


'aitiless Childbirth 

and diseases of 
Women and Children 



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Very respectfully, 
Dr. J. H. DYE MEDICAL INSTITUTE, 
Buffalo, N. Y. 



ILLUSTRATED EDITION OF 



PAINLESS CHILDBIRTH 



OR 



Healthy Mothers 



AND 



Healthy Children 



A BOOK FOR ALL WOMEN 



BY JOHN H. DYE, M. D. 

BUFFALO, N. Y. 



SEVENTEENTH EDITION 

Revised ;md Enlarged by Members of the Staff 

of the 

Dr. J. H. Dye Medical Institute 

Buffalo, N. Y. 



vnA 






Copyrighted, 1912, by 
Dr. J. H. DYE MEDICAL INSTITUTE 



SCU 309456 



PREFACE 



SIX thousand years of agony! Six thousand years 
of unnecessary suffering! It seems scarcely cred- 
ible, yet it is a fact, that for all these years our race 
has been perpetuated in pain and anguish. What a 
sacrifice for woman to make on the altar of maternal 
affection, while all this time her male companion has 
accepted the tradional superstitions of the past that it 
must be, apparently satisfied to see her suffer in child- 
birth, with little or no effort for her relief or the pre- 
vention of her agony. 

Doubtless many to whom our views are presented 
will at first declare " Painless Childbirth" a prepos- 
terous idea, but it will be because they jump- at the 
conclusion before they investigate and consider the 
methods by which it is to be accomplished. It will be 
because they think that as woman has endured so 
much misery through all these years she must continue 
to do so for all time to come. 

To blindly accept the doctrine that our race can 
be perpetuated only in the midst of cruel pains is a 
pernicious submission to credulity and superstition 
almost as fallacious as it is wicked. 

Though it may be contrary to what is generally 



PREFACE 

observed I assert that the terrible agony woman suffers 
at childbirth is unnecessary, and may, in most cases 
at least, either be greatly modified or entirely overcome. 
In proof of this assertion scores of women have sub- 
mitted the plans detailed in the following pages to 
the test of practical experience with the most gratify- 
ing results. They have found that by following a few 
easy and simple instructions the duration of labor 
may be reduced to a few hours or minutes and that 
pains may be rendered so slight as to be scarcely 
worthy of notice. In addition, they have found that 
the same rules have entirely relieved the annoyances 
so often an accompaniment of gestation. 

I do not profess to have originated the idea that 
childbirth should be without pain, although so far as I 
am aware I have been first to show the relations be- 
tween the causes of pain and their remedies and put 
the same into a practical form that woman might avail 
herself of their advantage. I do not wish to be under- 
stood that no one else has done anything in this direc- 
tion. I have endeavored to give credit wherever it 
is due, and if I have failed to do justice in any case 
it has been unintentional. I do not hesitate to say 
that I have made use of their views and added my 
own; at the same time I have endeavored to render 
them all practicable and by the combination increase 
the advantages. 

I confess astonishment that obstetric literature 
should be so barren of suggestions for the prevention 
of pain at labor as it is. The genius of obstetricians 
seems to have been directed to the successful accom- 
plishment of labor rather than to the prevention of 



PREFACE 

suffering, consequently their art has been of advantage 
chiefly in difficult and protracted labors, which fortu- 
nately occur in but a limited proportion of births. 

My attention was at first directed to the fact that 
some women suffer so much more severely than others, 
and I was led to inquire why the sufferings of all 
might not be reduced to the minimum. The answer 
was that the physical conditions of all women were 
not equally favorable to the avoidance of pain. The 
next step was to decide, if possible, what caused these 
unfavorable conditions and to seek for a method by 
which they might be rendered more favorable. Physi- 
ology had taught me that all functions when properly 
performed, as nature had intended, should be without 
pain, and as childbirth is a natural function of woman 
I reasoned that it should be painless. It then remained 
to find means that would overcome these morbid con- 
ditions so generally attendant upon this function and 
make the process a painless one. How well I have 
succeeded, those who follow these suggestions will be 
able to answer. 

The accomplishment of this purpose necessitated 
overcoming as far as possible the diseases peculiar to 
women, and a separate chapter on this subject was 
prepared, describing such means as would be likely to 
prove successful in her hands, and which I have the 
satisfaction of knowing have been productive of great 
good, although in a few instances in which severe 
complications in the way of chronic diseases existed I 
have found it advisable to give special advice that 
could be of little use to the general reader in the con- 
duct of her own treatment. 

As the mother and child are so nearly inseparable 



PREFACE 

I have endeavored to give some practical advice re- 
garding the recognition and treatment of the diseases 
of early life, fully believing that the time-honored 
maxim, that "an ounce of prevention is worth a pound 
of cure/' still holds good, and if the mother recognizes 
the disease in its incipiency she may often call to her 
assistance such means as will prevent fatal conse- 
quences or avert lifelong affliction. 

Good, healthy children must always be regarded by 
the pure in heart as chief of " God's choicest blessings, " 
and it is to be hoped those whose homes are cheerless 
and desolate may find comfort in these pages as well as 
those who rejoice in the little darling's affection. Trust- 
ing that Healthy Mothers and Healthy Children may 
afford comfort to all classes and carry joy, happiness 
and health into the millions of homes over our broad 
land is the sincerest wish of 

The Author 



CONTENTS 



Chapter I. Sexual Attributes 9 

Chapter II. Maternity 18 

Chapter III. Is Pain Necessary? 29 

Chapter IV. Causes of Pain 39 

Chapter V. Conception and Pregnancy ... 52 

Chapter VI. Signs and Symptoms of Preg- 
nancy 64 

Chapter VII. Hygienic Management 70 

Chapter VIII. Dietetic Measures 83 

Chapter IX. Remedial Treatment 92 

Chapter X. Miscarriage 125 

Chapter XI. Preparing for Confinement . . . 132 

Chapter XII. Management of Labor 140 

Chapter XIII. Care of Mother After Delivery 163 

Chapter XIV. The Infant and Its Care 178 

Chapter XV. Feeding the Baby 201 

Chapter XVI. Diseases of Women 208 

Chapter XVII. Sterility 269 

Chapter XVIII. Diseases of Children 295 

Chapter XIX. Care of the Sick 405 



CHAPTER I 



SEXUAL ATTRIBUTES 

Co-existent with life itself — from the earliest 
period of human existence to the present, obedient to 
the Divine command, designed to subserve one of 
the grandest purposes of nature, essential to the 
preservation and continuance of our race — are the 
sexual attributes of man. 

Our first parents were created with the same physi- 
ological differences that characterize and distinguish 
the sexes today, and though they were created in a 
state of maturity there was engrafted upon their 
constitutions those self-same inherent properties that 
actuate mankind in the present, having been trans- 
mitted from parent to offspring through the process 
of generation. 

What love is to the soul, the sexual attributes are 
to the physical part of man. Love is the rudimental 
element of the soul, the essence of the Almighty; 
sexual attributes, the medium through which the spirit 
essence is transmitted to and engrafted upon the 
physical being. Both are divine gifts, in perfect har- 
mony with man's happiness and conducive to his 
enjoyment. " Love constitutes the foundation of human 



10 PAINLESS CHILDBIRTH 

nature;'' it is the motive power, as it were, of our 
impulses, actuating, regulating, refining human char- 
acter. " Sexuality implies reproduction" and, asso- 
ciated with love, is an instinct, the office of which is 
to repair the ravages of death by a continual trans- 
mission of life. The sexual passion is one of the most 
powerful impulses, and when subordinate to reason 
and love its purpose "is rather to subserve the object 
of continuing the species than merely its own gratifi- 
cation." "Sensuality is an unbridled desire which 
kills the soul. " "It degrades love and brutalizes man. " 

Man is a rational being, endowed with reasoning 
powers, capable of comprehending his attributes and 
understanding the laws of their application. It is his 
duty to understand and observe whatever contributes 
to his happiness and avoid whatever may cause suffer- 
ing and misery. Ignorance will not protect us from the 
penalties of broken laws. 

It is by no means the author's wish to offend the 
fastidious or pander to depraved tastes, yet the con- 
viction is constantly forced upon him that if the public 
were better instructed upon sexual questions far less 
suffering and crime would exist. "The proper study 
of mankind is man," and it is very appropriately said, 
"knowledge is safety." Reason instead of instinct 
should govern our acts. The attributes capable of 
contributing to our enjoyment as well as preserving 
our lives are too often perverted and abused, and thus 
become sources of pain and death. It is, therefore, 
proper that we understand these facts and live accord- 
ingly; that we govern our passions instead of permitting 
them to govern us. This we cannot do if we do not under- 
stand the relations between cause and effect. 



SEXUAL ATTRIBUTES 11 

If we are ignorant of the necessity of restraining 
our animal propensities and of keeping them within 
proper bounds, if we do not know their boundaries 
or if we are ignorant that we incur certain penalties 
if we overstep these boundaries we will be constantly 
liable to violate both divine and natural laws and be 
punished for the same, though at the same time not 
realize what we are being punished for. The majority 
of people blame Providence for their afflictions, while 
the truth is they have, though perhaps unwittingly, 
broken some law of their existence. It is not the 
author's intent to enter into the consideration of these 
laws and their effects in this work any farther than re- 
lates to the causes of pain in maternity and how to 
avoid them, yet he hopes these hints will lead the 
reader to investigate the laws of life and the penalties 
imposed for violating them. 

Neither sex is complete in itself, but the diversity 
attracts the one to the other — to complete the one by 
union with the other. Neither alone is capable of 
transmitting life, and their union is necessary not only 
for the welfare of each other but also for the purpose 
of carrying out the divine command, " multiply and 
replenish the earth/ ' This attraction of the sexes 
"is the basis of marriage and of the laws and customs 
which recognize the life-choice of one woman for one 
man." 

When love is pure and true it does not find its complete satis- 
faction except in the indissoluble bond of marriage. Marriage 
is its natural consummation. 

Before sexual union it is the man who loves the most ear- 
nestly, because he sacrifices more — pains, marches, contests; he 
spares nothing. 

When the act is consummated, it is, in her turn, the woman 



12 PAINLESS CHILDBIRTH 

who loves more and for a longer time. Then her love becomes 
labor and suffering; she must nourish with her blood the being 
to which man has communicated life; she must bring it into the 
world in the midst of cruel pain; she must continue for it in- 
cessant cares. — Bourgeios. 

Most observers concede that the sexual passion is 
stronger in men than in women; indeed, some women 
have none at all; and though the absence of this passion 
is in most cases the result of disease or the early abuse 
of this function there are cases met with in which 
sexual apathy is the only abnormal condition present. 
In such cases philoprogenitiveness may be perfectly 
developed, and I have met many cases of the kind 
where women have become mothers without experien- 
cing any sexual emotion whatever. 

There is another class in which a proper and natural 
degree of passion exists, while in still another though 
smaller class it exists in an unnatural degree, often 
amounting to nymphomania, a disease manifested by 
excessive erotic desires which are controlled with 
great difficulty, if at all. Those of the first class, in- 
capable of experiencing the emotions that influence 
and control the latter, regard them with contempt 
and hatred, when pity would be far more proper. 
Fortunately, such abnormal conditions are amenable 
to proper therapeutic measures. 

There should be neither passion, pleasure nor pain 
which is not shared by both sexes. Generation is a 
duty; " Children are a good and not an evil, " and the 
feelings that impel to reproduction are as much a part 
of nature as is the hunger or thirst that prompts us 
to eat or drink. But it is a physiological fact that the 
moderate use of any function contributes to health, 



SEXUAL ATTRIBUTES 13 

longevity and enjoyment, while excessive indulgence 
is punished with physical ills.* 

Although it is possible for conception to occur 
where no sexual passion is manifested, nevertheless 
it is true "that the disposition of the woman at that 
time has much power in the formation of the foetus, 
both in modifying its physical constitution and in 
determining the character and temperament of its 
mind. " 

Her influence over the unborn does not by any 
means end with conception. For nine months she 
continues to impress upon it mental and physical 
characteristics that to a very great extent shape its 
future course and determine its usefulness in society. 
The moral influence of the mother must not be for- 
gotten; for it is while the rudimental brain and nervous 
system are being developed that impressions are easiest 
made and most apt to remain. Small influences at this 
time may grow into great variations of character in 
future. 

True, the impress of the father will be seen in the 
child, but it is during gestation that the foetus is a 
part of the mother herself — "blood of her blood, 
bone of her bone " and, we may add, nerve of her nerve. 

Circumstances that influence the life of the mother 
during this interesting period necessarily exert a simi- 
lar influence upon the child in a greater or less degree. 
The stronger constitution of the mother may not be 
permanently impressed by external influences, while 
the child may be so affected that a life-time will not 

*In this consideration, the author is desirous of being understood to mean 
reproduction, under such moral and social laws as govern the people where it 
takes place; it not being his intention to discuss monogamy, bigamy, polyg- 
amy or promiscuity in this work. 



14 PAINLESS CHILDBIRTH 

be long enough to efface them. Thus hereditary charac- 
teristics are transmitted and developed; thus ante- 
natal influences shape the destiny of the unborn. 

Excessive gratification of the sexual passions ex- 
hausts the vital and nervous forces, deranges the vege- 
tative functions and lays the foundation of various 
diseases; and the diseases and physical conditions of 
the parents at the time of conception and during ges- 
tation will materially modify the constitutions of their 
offspring. 

While the reproductive organs are not the seat of life, it is a 
well-established fact in physiology and pathology that they 
exert a most profound influence upon the performance of every 
function of the animal economy. Concerned as they are in the 
transmission of life, it is through them that vital and other char- 
acteristics are handed down to posterity, so that the welfare of 
the future generations depends materially upon their inheritance. 
Children born of parents suffering from diseases of these organs 
are generally defective in vital and other qualities, ill-tempered, 
sickly and short-lived. — Baker. 

Children born of parents of fair intellectual qualities, 
but who have indulged their animal propensities to 
such an extent that they are suffering vital defects, 
will usually be bright, keen of perception, have large 
heads, but will be physically weak, fall easy victims 
to diseases of various kinds and in very many instances 
die under ten years of age. Sometimes the arts of the 
physician will avert those fatal tendencies of such 
constitutions, but were he able to do this far oftener 
than he is how much better would it be to know the 
laws that regulate such conditions, and by living in 
obedience to them avert the penalties of breaking 
them. Even though cures for diseases were always 
possible how much better it would be to prevent them. 



SEXUAL ATTRIBUTES 15 

Carry the question of vital transmission farther. 
Exhaust the vital qualities of the parents still more; 
set up the diseases that follow the breaking down of the 
system by excessive sexual indulgences, and the chil- 
dren will rarely have the redeeming qualities of the 
former class, but will be weak, idiotic, deformed and 
epileptic. 

Certainly the highest and holiest duties of earth are con- 
signed to woman; she is the one who moulds the physical form 
of her offspring and rears it to the stature of man and shapes its 
moral and intellectual destiny. The embryonic being draws nu- 
triment and subsistence from its maternal parent and derives 
its vital impress from the parent stock. Loveliness begets loveli- 
ness; purity begets purity; wisdom begets wisdom; selfishness 
begets selfishness; hatred, hatred; bad temper, bad temper; 
licentiousness, licentiousness; crime, crime; etc., etc. 

Excessive venereal indulgence, excessive child-bearing, ex- 
cessive nursing are terribly destructive to the vital forces of 
woman's organization. * * * This slavish drudgery to 
maternal requirements is the cause of many distressing disorders, 
producing irritability of temper and all those domestic contre- 
temps which so often destroy the happiness of the family relation 
and bring odium and disgrace upon the marital institution de- 
signed by the ordinances of nature and heaven for the highest 
felicity of man and woman in a state of terrestrial existence. — 
Pancoast. 

The influence of moderation in these matters cannot 
be overestimated. The evil influence of excesses are 
to be seen in both parent and child. As the excessive 
indulgences exhaust the vital forces, irritability is 
increased, the sensorium becomes more and more 
acute and trivial ills become severe pains or serious 
diseases, and the natural sensibility becomes so greatly 
exaggerated that the mother is subjected to continual 
agony both before and after birth. 



16 PAINLESS CHILDBIRTH 

The act of generation is a voluntary one, but nature has so 
placed it under the empire of pleasure that the voice of discre- 
tion is no longer heard and the will is led captive. Hence, it is 
well, for hygienic reasons, to consider its laws. 

Too frequent repetition of the reproductive act is known to 
be followed by consequences injurious to the general health. 
Too rigid continence is not unattended in many constitutions 
with danger, for the victory over passion may be dearly bought. 
Science recommends the adoption of a wise mean between the 
two extremes equally destructive. By following her counsel, 
woman may escape from the hysterical and other disorders 
which often wait as well upon excesses as upon the too great 
demands of that passion which claims satisfaction as a natural 
right. — Napheys. 

The interests of man and woman are the same. 
Their object is to promote their own happiness, to 
prolong their own lives and to perpetuate the race. 
The higher degree of perfection they attain, the greater 
their enjoyment, the greater their immunity from suffer- 
ing. Pleasure should never be bought at the expense 
of pain. Each succeeding generation should be more 
perfect than its predecessor. Our race is susceptible 
of culture, but it cannot be trusted to chance. 

Certain definite and well-regulated laws are in exist- 
ence throughout the universe. These rules must be 
understood and obeyed. Obedience will be rewarded 
and transgression punished. The providence of God 
asks nothing unreasonable of us, nor will it be likely 
to suspend any of its rules to favor an erring mortal. 
Ignorance will not be accepted in extenuation of dis- 
obedience. The child that puts its tiny finger into the 
fire, ignorant of what the result will be, is as certainly 
burned as the older one who knows the consequences. 
The insane man leaps from a precipice and is dashed 
to pieces on the rocks below. He breaks the law of 



SEXUAL ATTRIBUTES 17 

gravity and pays the penalty with his life. The law 
of gravitation is not suspended because he is unac- 
countable for his act. So with all other natural laws. 

Pain is the result of having broken some law. Had 
the law not been broken, the pain would not have 
been felt. These are facts. They look us squarely in 
the face. We may reason from cause to effect, from 
effect to cause, the result is the same. The question 
plainly presented to every individual is : Is immunity 
from pain and suffering worth the little effort required 
to prevent them? It is purposed in the following pages 
to consider some of the causes of pain, and teach pre- 
vention. As we improve our condition and knowledge, 
greater results may be anticipated, but we shall derive 
immediate benefit. Improvement is a forced state; if 
we relax our efforts we shall be extremely liable to 
retrograde. 

We have shown that it is a fixed law that the capaci- 
ties and dispositions of the parent are engrafted upon 
the offspring. Sick parents beget sickly children. 
Parents who keep their sexual functions in a state of 
excitement beget children that will be precocious in 
this direction. Consumptives beget consumptives. 
Venereal diseases descend through several generations, 
blighting the lives of many in the descent. Stock- 
raisers study the law of hereditary transmission, and 
is the human race of less consequence? All these con- 
siderations have a more or less direct bearing upon the 
pains and perils of child-bearing, and it is designed 
in the following pages to specify these causes, explain 
their operations, point out both preventives and reme- 
dies and render each woman capable of painless child- 
birth. 



CHAPTER II 



MATERNITY 

The office of maternity is peculiarly that of woman, 
and is the highest and holiest to which she can aspire. 
Its attainment requires many sacrifices which she is 
ever ready to make, and she considers herself amply 
repaid for the pains and perils she has to undergo when 
she clasps to her breast her new-born babe, the culmi- 
nation of her anxiety, the central object of her affec- 
tions, to her the crowning blessing of earth. 

Maternity is a legitimate object of woman's exist- 
ence, to be attained only through the exercise of a 
certain function which, for the welfare of society, is 
not to be indulged outside of the marriage institution. 
For this reason, if for no other, the parties to a marriage 
contract should study the law of adaptation. Each 
party should possess good health, be free from any 
hereditary taint, and be by disposition prepared to 
reciprocate the love of each other. To love and be 
loved, to forgive and be forgiven is essential to the 
happiness of both. 

Philoprogenitiveness or love of offspring is a faculty 
that " renders children the richest treasure of their 



MATERNITY 19 

parents, and casts into the shade all the toil and ex- 
pense they cause and lacerates them with bitter pangs 
when death or distance tears them asunder. It is 
much larger in woman than in man. " The father may 
love his children earnestly, ardently, but it is different 
from the love of the mother. His affection may be 
turned away from them, but the love of the mother 
endureth to the end. 

The intensity of a mother's love is manifested in the 
sacrifices she makes to secure her child's happiness. 
Perhaps forsaken by the father of her babe she strug- 
gles on alone in the world, careless alike of frowns 
and hardships, only intent upon its welfare. Dying, 
her last prayer is for her child. 

She deprives herself of innumerable pleasures, fore- 
goes the enjoyments of society, assumes the risks of 
unknown dangers, endures the pains of childbirth — 
many times suffering from the earliest period of ges- 
tation until long after delivery, to attain the joys of 
motherhood. 

Maternity begins with conception and ends only 
with the grave. Maternal instincts may exist in early 
life, and in the barren, but she must pass through the 
process of gestation and undergo the ordeal of delivery 
— she must, in a word, become a mother — before she 
can fully realize what maternity means. 

The adaptability of the female to the requirements 
of this important office is manifested very early in 
life — in childhood. While the boy plays with his ball, 
his horse and gun, manifests ambition, courage, power, 
exhibiting his aspirations to manhood, the little girl 
plays with her doll, imitates the matron and by word 
and act indicates her wishes for a "real baby" long 



20 PAINLESS CHILDBIRTH 

before she can possibly realize even in the slightest 
degree the difficulties and dangers the gratification 
of her desires imply. 

Though it is through sexuality that maternity is 
to be attained, the maternal instinct is entirely dis- 
tinct from the sexual impulse, and the realization of 
maternity is often experienced without any knowledge 
whatever of sexual gratification on the part of the 
mother. 

Professor Lay cock says : 

Maternity is the first and fundamental duty of the female; 
the male never in a single instance, in any organism, contrib- 
utes nutrient material. 

Madame Sirrey says: 

Those women who comprehend their rights and duties as 
mothers of families certainly cannot complain of their destiny. 

The office of maternity is respected the world over. 
In ancient Rome, the house of the newly-made mother 
was designated by the suspension of wreaths over the 
door to prevent intrusion and as a mark of reverence. 
To encourage this holy office various countries have 
legislated in its favor and pensions have been awarded 
to women who have borne many children. 

AH women are not fitted for the duties and respon- 
sibilities of this holy office. There are a variety of 
circumstances that should be considered in contem- 
plating maternity. When one or both parents are 
suffering from diseases that influence primarily their 
vitality and are liable to be transmitted to their 
progeny they have no right to bring beings into the 
world who must perpetuate the parents' misery by a 
life of continual suffering. Diseases or infirmities which 



MATERNITY 21 

threaten directly the physical or moral life of the 
individual are propagated above all by generation. 

The different forms of mania are liable to be aggra- 
vated by genital transmission. Epilepsy is liable to 
degenerate into cerebral maladies in the offspring. 
Consumption perpetuates itself in the race and may 
become contagious for the other parent. Uncured 
syphilis is transmitted through several generations. 
Improper temperamental alliances often develop dis- 
ease among children where it had not been manifested 
in the parents. We should seek in marriage to neutralize 
by opposing constitutions, temperaments and pre- 
dispositions the morbid hereditary elements which may 
be found in husband and wife. Marriage alliances 
should never be contracted between two persons who 
are essentially the same in temperament. We should 
seek to oppose the debility of one parent by a strong 
constitution in the other. When matrimonial contracts 
Ere formed contrary to the above rules the wife should 
sacrifice her maternal desires for the welfare of the being 
she would otherwise bring into the world, lest she 
entail upon the prospective object of affection a 
life of continuous misery. Among the lower animals 
the most studious care is taken to breed only from the 
very best quality of stock; quantity is sacrificed to 
quality; and is the welfare of the human race of less 
importance? 

We contend that no parents have a right to beget 
more children than they can comfortably support, 
and we appeal to the nobler sentiments of our fellow 
men in support of our position. We assert that it is 
the privilege of every woman to control her maternal 
function — to say when she shall have children, and how 



22 PAINLESS CHILDBIRTH 

many. It does not follow because she is married that 
she shall be robbed of her health and every enjoyment 
in life, in compliance to the sexual behests of her com- 
panion; and no man of feeling, sense or decency will 
be willing to see the health, the beauty and the enjoy- 
ment of his wife sacrificed to excessive child-bearing. 

A host of writers — medical and non-medical — are 
arrayed against the subjection of woman to the infa- 
mous laws of modern civilization which are too often 
upheld by religion. By the laws of our country it is 
a criminal offense to procure or aid in procuring or to 
instruct any woman by what means she can regulate 
the number of her offspring by preventing conception. 
Under this law she must beget children, even though 
she knows they must suffer and die of some hereditary 
malady. Under this law she must beget children and 
bring them up in poverty, and subject them to starva- 
tion, vice and crime. But one alternative is left, and 
that is the criminal one of foeticide or child-murder! 
Indeed, this law demands that she sacrifice health, 
happiness, principle, and even life, in obedience to the 
demands of this most infamous enactment, in the 
passage of which she had not even a minority vote. 

Could the one single law of Providence governing 
reproduction be suspended or reversed, and every man 
be compelled to have just one child, even though they 
might have the benefit of the following rules, the first 
act of our next Legislature would be the repeal of this 
obnoxious law, and every man would provide himself 
with a preventive. 

The distinguished writer, John Stuart Mill, says: 

It is strange that intemperance in drink or any other appe- 
tite should be condemned so readily, when incontinence in this 



MATERNITY 



23 



respect should always meet not only with indulgence but praise. 
Little improvement can be expected in morality until the pro- 
ducing too large families is regarded with the same feeling as 
drunkenness or any other physical excess. 

The eminent Raciborski, in taking the position that 
avoidance of offspring to a certain extent is not only 
legitimate but should be recommended as a measure 
of good, says : 

We know how bitterly we shall be attacked for promulgating 
this doctrine, but if our ideas only render to society the services 
we expect of them we shall have effaced from the list of crimes 
the one most atrocious, without exception, that of child-murder — 
before or after birth — and we shall have poured a little happi- 
ness into the bosoms of despairing families where poverty is 
allied to the knowledge that offspring can be born only to pros- 
titution and mendacity. The realization of such hopes will 
console us under the attacks upon our doctrines. 

Dr. Edward Reich says: 

After reviewing the multitudinous evils which result to indi- 
viduals and society from the too rapid increase of families it is 
much to be wished that the functions of reproduction be placed 
under the dominion of the will. 

Dr. Napheys remarks: 

Men are very ready to find an excuse for self-indulgence, and 
if they cannot get one anywhere else they seek it in religion. 
They tell woman it is her duty to bear all the children she can. 

In his work on Fecundity, Fertility and Sterility, 
Dr. Duncan, in considering the subject of the size of 
families, says: 

Neither the arguments of Malthus, nor any others, apparently 
justify us in calling on a healthy couple to limit the number of 
their children when they will receive a fair education and such 
an outfit as will enable them to produce so much wealth by their 
labors as will probably insure them against want. It may well 
be doubted whether, for the sake of self-indulgence and with a 
little more wealth, such a couple would be justified in placing a 



24 PAINLESS CHILDBIRTH 

limit to the number of their children. But think of another and 
too frequent case. Think of a man and woman struggling with 
poverty absolute or relative, with more children already than 
they know how to educate, to clothe, even to feed ! Think of 
the woman bowed with ill health, peevish from petty trials! 
. Think of the children, each on its arrival regarded as a misfor- 
tune if not a curse, growing up unhealthy, ill-cared for, dirty, 
ignorant, with no better prospect than to repeat the life of its 
wretched parents! Would these parents do wrong in refusing 
to be instrumental in multiplying a race of paupers? Between 
these two extremes may not each man and woman ask themselves 
the question whether any duty obliges them to procreate chil- 
dren whose advent they will deplore? 

Some may be shocked even at the question, regarding the 
births of children as the special intervention of Providence. 
We shall not quarrel with these persons, remembering what are 
the faculties and possible destiny of each child born; but we 
cannot refuse to see that Providence will not send children 
without some action on our part. There is no obligation binding 
on men and women to begin the begetting of children. Having 
begun, must they go on perforce? The argument as to interfer- 
ing with Providence is quite disregarded now as to epidemics, 
and it is a little difficult to see the distinction between interfer- 
ing to prevent excessive deaths and excessive births. Indeed, if 
we disturb the old balance by preventing a high death-rate, it 
seems almost incumbent on us to restore the equilibrium by 
diminishing the birth-rate. It seems a strange doctrine that we 
with our privilege of free-will, with reason, with religion for our 
glides shall be debarred all choice in this matter, and be reduced 
to a level with brute beasts, each species of which is limited by 
death and suffering alone. We wholly disagree with those who 
indulge their senses and expect Providence to protect them from 
the consequences of their incontinence. 

I am convinced from careful study and extensive 
research that society or population would not suffer 
if the act of generation was wholly under the dominion 
of the will, for there are as many sterile women who 
desire children as there are fertile ones who wish to 



MATERNITY: 25 

avoid them. The force of this observation is more 
apparent when we assert that in about ninety-five 
per cent of cases of sterility the barrenness is caused 
by diseases, and may be corrected. 

The intelligent and impartial consideration of the 
subject is necessary 7 and should be taught rudimentally 
in our schools, even though it were advisable to estab- 
lish special schools for the purpose. The law against 
preventing conception does not regulate the number of 
illegitimate children nor diminish prostitution : for if 
the fear of conception is the only barrier the law opposes 
to the unlawful indulgence of the sexual propensities 
it is too feeble to merit a moment's thought. The 
immoral care nothing for it while, on the other hand, 
wives who cannot resist or evade the responsibilities 
are often compelled to beget offspring under circum- 
stances of the most lamentable and cruel kind. 

Had woman the possession of herself and the control of her 
maternal functions and duties, instead of grievous sufferings and 
privations, she would have health and beauty; not only of her 
own organization, but she would become the mother of children 
equally vigorous and lovely. Surely, nothing is more wicked 
than to bring into the world such numbers of helpless and inno- 
cent beings to doom them to poverty, ignorance and crime, 
because of their parents' inability to make necessary provision 
for them. — Pancoast. 

I have no wish or intent to break any law nor encour- 
age others to do so, no matter how unjust it may be, 
but for the sake of the oppressed I seriously hope the 
attention of legislators will be given to the matter and 
that it may receive proper scientific investigation. 

The influence of the mother over the career of her 
child is immense, and it should be rightly directed. A 
noted divine has well said, "to be good mothers of 



26 PAINLESS CHILDBIRTH 

men and women is the greatest thing in all this world" ; 
and we will add, the better the mothers the better 
the children in every respect, for 

"The hand that rocks the cradle is the hand that rules the 
world." 

Physical conditions may be cultivated, but the germs 
must first exist. It is difficult to give other than what 
we have or transmit what we do not possess. 

It is a mistaken notion among many newly-married 
people that they do not want children. Many who 
have thought thus have had occasion to regret their 
folly, when later in life the wife finds herself perma- 
nently sterile or suffering from disease which the un- 
philosophical and unphysiological methods of pre- 
venting conception she has practiced, entail. 

The age of the wife has an important bearing upon 
not only her health, her fertility and severity of labor, 
but upon the constitution of her offspring. Every 
man and woman should possess a plenitude of life 
before they communicate it to another. The body 
should have attained its growth for at least a year, 
and every function be fully and perfectly established. 
After puberty the pelvis of the female undergoes im- 
portant anatomical changes to fit her for child-bearing. 
These changes require time (several years), and it is 
not until they are completed that she is fully qualified 
to perform her part in the process of reproduction. 

Comparison of the skeletons of males and females 
after puberty shows a marked difference in their relative 
breadth and depth, that of the woman being greatest, 
for two reasons, viz.: The accommodation of certain 
organs which are peculiar to her alone and the easy 
expulsion of the foetus when conception is completed. 



MATERNITY 27 

The age at which this pelvic difference matures varies 
from twenty to twenty-five, and conjugal unions should 
not, on an average, be formed prior to the earliest 
period indicated. Between twenty-five and thirty is 
the period of the greatest fertility, and first confine- 
ments between these ages are least difficult and dan- 
gerous. 

Aristotle observed : 

To the female sex, premature wedlock is particularly danger- 
ous, since, in consequence of anticipating the demands of nature, 
many of them suffer greatly in childbirth and are liable to pro- 
duce imperfect offspring. 

His observations are fully confirmed by writers of 
the present day. The children of such marriages are 
sickly, puny and defective in mind and body. They 
inherit more readily the defects of their ancestors and, 
as a rule, die at earlier years than the progeny of 
better-timed unions. 

Dr. Naphey says: 

A too youthful wife finds marriage not a pleasure, but a pain. 
Her nervous system is prostrated by it; she is more liable to 
weaknesses and diseases of the womb; and if of a consumptive 
family she runs great risk of finding that fatal malady mani- 
fested after a year or two of married life. It is very common 
for those who marry young to die young. 

Admitting that there are many exceptions to this 
rule it is no argument in favor of early marriages, 
because there is nothing to be gained except in rare 
instances. It has been argued in favor of early mar- 
riages that uterine diseases in young girls are sometimes 
cured by it. The risk is too great, for in every case 
where one has been benefited hundreds have been 
made worse. My own observations of the results of 
early marriages conform to the foregoing. Many 



28 PAINLESS CHILDBIRTH 

mothers have suffered from uterine and nervous dis- 
eases while their children have possessed puny con- 
stitutions. 

On the other hand, marriages late in life are equally 
objectionable. Barrenness is more frequent after 
thirty, while the first labors after that age are apt to 
be more protracted and dangerous. The farther this 
period has passed the more rare first births become, 
and at forty-six the child-bearing period of woman 
ceases entirely, though some notable exceptions have 
been known* 



CHAPTER III 



IS PAIN NECESSARY? 

To the child-bearing woman, few questions are of 
greater import, and it is to be hoped the writer will 
be able to convince his readers that the question may 
be truthfully answered in the negative. 

When we observe the little suffering the lower ani- 
mals experience in bringing forth their young we are 
at once led to inquire : Is it necessary that the human 
female created in the image of God should suffer as 
she does in childbirth? Why is she specially selected 
to endure such agony? Can the Almighty have any 
special design in afflicting her thus? 

Physiologists tell us that the healthy performance 
of any function is unattended with pain; that natural 
processes are painless and that pain is the result of a 
morbid condition. It is conceded that child-bearing 
being necessary to the perpetuation of our species is 
the natural function of woman; consequently, if we 
accept the doctrines of physiology, we can only infer 
that childbirth should be without peril and without 

PAIN. 

We cannot believe that the Almighty ever intended 
woman should suffer such terrible misery, while her 



30 PAINLESS CHILDBIRTH 

male companion equally interested in its results should 
wholly escape. If such be the design and it is neces- 
sary then why do some suffer so much more than others? 
If the descendants of Adam are enabled by any means 
to practically escape the curse pronounced in the garden, 
why not the descendants of Eve? 

This may seem sacrilegious to those who are ever 
ready to blame Providence for their mishaps; but 
while we respect the opinions of all we cannot help 
noticing that those who are the most ready to attri- 
bute to the dispensation of Providence all their ills 
are generally very prompt in seeking human interpo- 
sition to mitigate the suffering occasioned by such 
special dispensation. A genuine attack of colic or 
cholera morbus will take the special dispensation doc- 
trine out of a man in very short order; and though he 
may pray for another special dispensation to relieve 
him he is generally anxious that a speedy messenger 
be dispatched for a doctor about the same time; and 
what is colic or cholera morbus in comparison with 
the pains of childbirth? Let those who have experi- 
enced both answer. If it is right to relieve the pains 
of one by human efforts is it not right to relieve or 
prevent the agony of the other? 

The truth is, Providence is no more to blame for 
the suffering of one individual than of another, and 
will not suspend or reverse any law to accommodate 
anybody. We are born subject to certain organic 
laws, and if through wilfulness or ignorance we violate 
them we must suffer the consequences. Providence is 
no more to blame for disease and pain than for picking 
of pockets or stealing horses. We have charge of our 
constitutions, and if we will not learn how to care for 



IS PAIN NECESSARY? 31 

them — learn how to prevent disease and pain — we 
must suffer, and no interposition of the Almighty need 
be expected, nor will the plea of ignorance be accepted 
in extenuation. 

For our part w r e cannot believe the Almighty the 
cruel, merciless tyrant many picture Him, but believe 
in His wisdom, mercy and justice. He has placed at 
our disposal abundant means for our relief if we will 
but comprehend and apply them. 

It is not our purpose, however, to discuss the pain 
question upon its theological merits, still if there is 
the efficacy in prayer that has been accorded to it 
the pains of childbirth are a consequence of the curse 
uttered in Genesis 3 : 16-17; and if the purposes of 
the Almighty are ever changed it would seem that 
there have already been prayers enough offered for 
woman's deliverance to have effected it, for certainly 
she has suffered enough to satisfy the devil, much less 
a God. 

Perhaps some enthusiastic Malthusian will set up 
the claim that the pains and perils of childbirth are 
necessary to constitute a check upon over-population. 
If that is the case, it would appear that after being 
tested six thousand years and proving a failure it is 
about time the plan was abandoned and some other 
one tried. 

It is very evident that all women do not experience 
the same degree of suffering, and we infer there must 
be some good reason for the difference. Every effect 
must have a cause, and the question arises: Are we 
not capable of ascertaining the reason why some suffer 
less than others and, by applying the same conditions 
to all, ameliorate the suffering of all? 



32 PAINLESS CHILDBIRTH 

Travelers tell us that the females of uncivilized 
nations suffer less in childbirth than those of civilized, 
and we cannot entertain the idea that the heathen 
mother is more a favorite in- sight of heaven than her 
Christian sister. Hence, some other explanation is 
necessary, and we come to believe that the difficult, 
painful and tedious labors are due to some physical 
condition of civilized woman which the uncivilized 
escape. 

The uterus is a hollow, muscular organ that grad- 
ually enlarges as gestation goes forward until the termi- 
nation of pregnancy when, for certain reasons unneces- 
sary to consider in this connection, it contracts and 
after repeated efforts expels its contents amidst intense 
suffering. 

The heart is a hollow, muscular organ that by its 
alternate expansion or dilation and contraction re- 
ceives the blood from the veins and sends it coursing 
again through the arteries to every part of the body. 
Its contractions are forcible and represent an amount 
of muscular power immensely greater than the uterus. 

The stomach is also a hollow, muscular organ that 
by its contractions and motions churns, mixes and com- 
minutes its contents until prepared for expulsion. 

The bladder is another hollow, muscular organ that 
dilates slowly as the urine accumulates within its 
cavity until a certain degree of distention is reached, 
when it contracts and the urine is expelled. 

All of these organs are supplied with nerves of sen- 
sation, yet they perform their natural functions with- 
out pain. 

The general structure of the uterus is similar to the 
other organs mentioned and expels its contents by 



IS PAIN NECESSARY? 



33 



contractions in a manner similar to the others; then 
why should its operations be attended with pain and 
the others escape? This reason is plain. The heart, 
stomach and bladder are in a healthy condition, and 
in that condition not sensitive to pain. Let them become 
affected by disease and every contraction they make 
is performed in agony. 

In dyspepsia the stomach becomes diseased and the 
dyspeptic knows w T hat it is to suffer; yet he does not 
believe his pain is necessary and quietly submit to it 
without an effort to effect a cure. 

Inflammation and other diseases of the heart create 
intense suffering and disturb every function of the body. 

When irritation or inflammation of the bladder occur, 
every contraction is attended with the most excrucia- 
ting agony. 

Thus it must be apparent that when these organs 
are in a healthy condition their functions are painless 
and are performed in an almost unconscious manner; 
but, when a pathological state is developed, agony is 
the result. 

From this we rationally infer that the reason the 
contractions of the womb are attended with pain is 
because some morbid condition of it or adjacent 
structures exists. 

All accouchers have remarked that cases are often 
met where the contractions of the womb are prolonged 
and vigorous, and yet the woman will complain very 
little. From this we are led to infer that the anatomical 
construction of the parts is favorable to the process, 
and that the uterus and its attachments have not been 
rendered sensitive by morbid conditions. A healthy 



34 PAINLESS CHILDBIRTH 

uterus is not sensitive, and parturition should be painr 
less. 

The eminent obstetrician, Dr. Dewes, argues: 

Pain in childbirth is a morbid symptom; that it is a perversion 
of nature caused by modes of living not consistent with the 
most healthy condition of the system, and that such a regimen 
as should insure such a completely healthy condition might be 
counted on with certainty to do away with such pain. 

Prof. Huxley says : 

We are, indeed, fully prepared to believe that the bearing of 
children may and ought to become as free from danger and 
disability to the civilized woman as to the savage. 

Pancoast, in his Ladies 1 Medical Guide, says: 

It is a common belief that gestation is a period of disease and 
suffering, and that parturition is inevitably a painful and danger- 
ous process. Now the great truth yet to be learned is the reverse 
of such impression. It is just as natural for a woman to bring 
forth children as for a shrub to produce flowers and fruit. In a 
state of health no natural process is painful. Pain, in all cases, 
is a sign of disease — it has no other significance. In its healthy 
condition the uterus receives the germ of a new being, provides 
it with proper nourishment, expands to make room for its de- 
velopment and, at the time appointed by nature, dilates its 
opening and contracts — a series of involuntary and painless 
muscular efforts — so as to throw the infant into the new exist- 
ence which its growth demands. It performs its own proper 
functions, just as the lungs, the heart or the stomach perform 
theirs, because it was formed by the same Infinite Wisdom and 
Goodness who ordained that pain and sorrow should be the 
consequences of sin and who ordains that health and happiness 
shall ever be the result of obedience to the laws of life. 

It is well known that the slave women of this country 
required very little or no attention at confinement. 

Their labors are generally of short duration, the pain 
moderate and the woman is incapacitated from per- 
forming her usual avocations only a few hours. 



IS PAIN NECESSARY? 35 

Among the poorer classes, i. e., those who are robust 
but compelled to depend upon their daily toil for the 
necessities of life — the plainest food — to whom luxury 
is a stranger we often find the labor easy and speedy 
and often with no attendant, except, perhaps, the 
husband or a little girl — not even a midwife. The 
woman gives birth and in a few hours resumes her 
usual duties. 

It is generally known among the American Indians 
that the avocations of the squaws are seldom, if ever, 
interrupted by an inconvenience from pregnancy or 
labor, except for a very short period at the time of 
birth. My brother-in-law, Dr. S. T. Baker, who has 
spent many years on the western frontier among the 
Indians, where he had excellent opportunities to ob- 
serve and acquaint himself with their habits, assures 
me that a pregnant squaw does not occasion any con- 
cern from her companions. She performs the usual 
drudgery of her life up to the very hour of her labor, 
making no preparation for the coming "pappoose." 
When she realizes that the hour for delivery is at hand 
she enters her cabin or betakes herself to some stream 
or spring, gives birth, washes the young "Injun" in 
the cold water, straps it upon her back and before she 
has been scarcely missed has returned a full-fledged 
mother and resumes her labors unconscious of having 
undergone any very wonderful ordeal. If the band to 
which she belongs is on a march when she feels that 
labor is upon her she leaves the trail and beside some 
brook or spring spreads her blanket, is delivered, washes 
the infant, straps it upon her back, mounts her pony, 
gallops on after the rest, whom she overtakes after one 
or two hours' absence. If they experience any of the 



36 PAINLESS CHILDBIRTH 

annoyances of pregnancy that afflict the daughters 
of artificial life they pay so little attention to them as 
to attract no notice whatever. 

Caseaux remarks : 

There are certain females who have the happy privilege of 
being delivered without any or, at least, very inconsiderable 
pain. I had the opportunity at the clinique of observing a young 
woman in her first labor who was aroused by the pains at four 
o'clock in the morning and was delivered at six. During these 
two hours she suffered so little that she did not consider it neces- 
sary to alarm anyone until the pains became a little more severe, 
when the midwife was summoned and found the head had been 
delivered. 

Nearly all physicians can recall cases in their ex- 
perience when, having been hastily summoned, they 
have found on their arrival a few minutes later that 
delivery was completed and that they had been sum- 
moned as soon as the woman herself realized that the 
labor had begun. 

In an English work on midwifery we find the fol- 
lowing statements : 

That a respectable lady, the wife of a peer, was actually de- 
livered once in her sleep. In another instance a woman bore 
eight children without ever having labor pains, and her deliv- 
eries were so sudden and devoid of sensible effort that, in more 
than one instance, they took place under very awkward circum- 
stances. 

While practicing medicine in the eastern part of 
this state (New York) several years ago I was called 
several miles into the country to attend a case of 
obstetrics. On my arrival the husband informed me 
that his wife was not much sick and that he guessed 
that it was a false alarm. As it was storming violently 
and was near the dinner hour I concluded to have my 
horse cared for and get dinner myself before my return, 



IS PAIN NECESSARY? 37 

whether it was necessary to stay longer or not. On 
entering the house I found the wife assisting in getting 
dinner which was nearly ready. She remarked she was 
sorry to have called me out in such a storm for nothing. 
Dinner over, she resumed her household duties, but 
suddenly sitting down in a chair remarked that it 
was not a " false alarm " after all. We assisted her 
upon a bed as quickly as possible and in less than 
five minutes from the time she called her husband 
the child was born. The afterbirth was soon delivered 
and a good recovery followed. She assured me she had 
not experienced any pain. 

Such cases could be indefinitely multiplied, did 
space permit or if it were necessary, but admitting 
them to be exceptional cases they prove the possibility 
of painless childbirth. 

We know there are many authors who regard pain 
as essential to childbirth and think women must 
ever suffer as she does now; and we have been not 
a little surprised in examining obstetrical literature 
to find how little attention has been paid to consider- 
ing the causes of pain or to any effort toward preven- 
tion. The idea of making childbirth easy seems to 
have been wholly overlooked in the endeavors to 
develop means to relieve difficult labors. Evidently 
they have regarded this grand function of the uterine 
system a pathological instead of physiological process. 

The duration of labor is a subject upon w^hich con- 
siderable difference of opinion prevails. On account 
of the change the abdomen and its contents undergo 
at the time, the delivery should not be so quick but 
that the contractions of the abdominal muscles may 
have time to adapt themselves to the change, and from 



38 PAINLESS CHILDBIRTH 



one to three hours is not too long. This, however, is 
a much shorter time than is usually occupied, and 
labor is said to be " natural" when it lasts from six 
to thirty-six hours and the woman kept in bed two or 
three weeks. The dangers to be apprehended from too 
rapid delivery are rupture of the perineum, flooding 
or syncope. 

From the foregoing it must be evident to the unprej- 
udiced mind that childbirth is a natural process when 
the mother lives in accordance with the laws of health. 

Natural labor is an easy, short and painless act. 

Natural labor is never painful. 

The organic nerves that supply the uterus are never 
sensitive in a healthy state. 

Irritation, debility, congestion and inflammation 
render these nerves sensitive and painful. 

All pain, difficulty and danger are the consequences 
of violating natural laws. 

Banish disease, enforce hygiene, establish health, 
and labor will not be difficult. 

All of these assertions will be proven as we proceed, 
and full directions for relieving the pain or of prevent- 
ing it will be given that will convince those who try 
it that pain in childbirth is unnecessary. 



CHAPTER IV 



CAUSES OF PAIN 



The causes of pain at childbirth are various and 
may depend upon the condition of the mother or upon 
the condition of the child. These causes may be either 
remote or proximate, direct or indirect. In some cases 
the causes will have ceased long ago, but their effects 
will remain. 

Unhygienic customs beget morbid conditions and 
thus render natural processes painful. Any cause that 
can retard or oppose delivery and protract labor in- 
creases the suffering of the mother and, if continued 
beyond a certain point, endangers the life of both mother 
and child. 

Childbirth to be proper and painless requires that 
the shape of the mother be perfect; every organ must 
be developed and the pelvic bones be anatomically 
correct in shape. No deformity is admissible. The 
distance from the junction of the pubic bones to the 
sacrum must be sufficient to permit the passage of 
the child without too great a degree of pressure. There 
must not be any unnatural obstructions. The abdom- 
inal, pelvic and uterine muscles must possess sufficient 
power that they may complete the process without 



40 PAINLESS CHILDBIRTH 

undue delay when expulsive efforts begin. The 
nervous system must be quiet and the mind must be 
at ease. Every tissue must be healthy; no morbid 
conditions present. Then the child must not be de- 
formed, too large, nor its bones too much ossified. 
Secure these conditions and labor will be materially 
shortened in duration and the suffering reduced to a 
minimum. 

Modern social customs impose upon woman arti- 
ficial modes of life that impair her constitutional vigor, 
deform her body, pervert her functions, render her an 
easy prey to uterine diseases and to prolonged and 
painful childbirth. These customs are indirect or re- 
mote causes of pain, because they create conditions 
of life which, in their turn, render pain unavoidable. 
The uncivilized mother uninfluenced by fashion, with 
the abdominal and pelvic muscles well developed by 
the exercises to which her life subjects her, her hips 
broad and deep to support the burdens she must often 
carry, her nervous system not rendered acutely sensi- 
tive by debility or disease almost entirely escapes the 
pains and perils of childbirth to which the society 
woman falls a victim. 

Bring the matter nearer home, and let us compare 
the slavery of the two classes — the one woman a slave 
to fashion and society, the other a slave to physical 
necessity. The first, malformed by dress, the muscles 
undeveloped and the sensory nerves made intensely 
sensitive by disease and her manner of life, suffers long 
and severely at such times, while the other, well formed 
by nature, developed by the exercises her position in 
life necessitates, with no irritable or inflamed nerves 
to annoy her, pays no attention to it further than the 



CAUSES OF PAIN 



41 



inconvenience occasioned by a few days' absence from 
work and the additional tax upon her resources for 
the maintenance of her child. Again, during pregnancy 
and probably for some weeks after delivery, the suffer- 
ing of the fashionable woman has been continuous, 
while the other has scarcely noticed her condition. 

There is a noticeable difference in the degree of the 
anterior curvature of the spinal column at its lumbar 
portion, between the lower ribs and the hips, in the 
two classes of women — the society lady's back bending 
inward or forward considerably the most, so that the 
power of the vertebral pile to support weight from above 
downward with ease is diminished on account of the 
greater angle, giving rise to the sensation of " backache 
as if it would break in two." 

This is one of the results of tight-lacing and insuffi- 
cient physical culture, and to anyone who will consider 
physical laws its influence in producing female diseases, 
in prolonging labor and increasing its pain must be 
obvious. This increased curvature throws the abdo- 
men forward beyond the direct line of the body and, 
in childbirth, much of the abdominal muscular effort, 
particularly of the diaphragm, is lost, because it is 
expended in the direction of a line with the pubic 
bones instead of the cavity behind them, the pubic 
bones opposing a force that no muscular effort can 
overcome, even were such a result desirable. In such 
cases the labor is protracted on account of the improper 
direction of the muscular force which is often feeble 
on account of the customary inactivity of the muscles 
preventing their natural development. 

The woman who in her daily labors is compelled 
to perform such exercises as develop all her muscles, 



42 



PAINLESS CHILDBIRTH 



particularly the erector muscles of the spine, to sup- 
port the heavy weight she is often obliged to carry, 
by developing a natural condition prevents the extra 
curvature the other sustains, so that when labor comes 
upon her the abdominal muscles acting in harmony 

Figure 1 




Position of organs in women 
with natural waist. 



Position of organs in women 
with waist deformed by tight 
lacing. 



with the efforts of the uterus, effect an easy and quick 
birth, because no force nor effort is lost by being directed 
in a line deviating from the direction the child must 
take to make its exit. 

Another way in which tight-lacing becomes a cause 
of painful childbirth is by confining the movements 
of the diaphragm so as to enfeeble it ; at the same time 



CAUSES OF PAIN 43 

the abdominal viscera are compressed into a space too 
small for the healthy performance of their functions, 
and being prevented from escaping upward naturally 
gravitate downward and by their pressure displace 
the organs of the lower abdomen into the pelvis. The 
circulation is thus rendered defective, and the vitality 
of the pelvic organs being impaired they become con- 
gested, sore, tender, irritable, painful, diseased — a 
condition of things that necessarily causes pain at 
childbirth. 

Deformities of the bony structures of the pelvis 
necessarily increase suffering and imperil the lives of 
both mother and child in a direct ratio with the degree 
of deformity. In such cases child-bearing should not 
be attempted, for when the deformity is so great that 
instrumental delivery is impossible but one of two alter- 
natives remain: Embryotomy or Caesarean section — 
the first of which sacrifices the child, and the second 
is pretty certain to sacrifice the mother. 

Tumors within the pelvis retard and endanger de- 
livery according to their situation, size and structure, 
and if they involve or press upon nerve filaments they 
occasion very great agony. Their removal must be 
effected before delivery. 

Inflammatory diseases of the womb necessarily in- 
crease the suffering. This organ is profusely supplied 
with nerves which are involved in the inflammatory 
process, and thus become acutely sensitive, as every 
woman who has been affected by it can testify. It 
is so sore and tender that the slightest touch is pain- 
ful, much less the severe efforts of parturition. In- 
flammation also gives rise to another source of pain, a 
change in the structure of the tissue inflamed by which 



44 PAINLESS CHILDBIRTH 

its elasticity is greatly diminished. Occurring in the 
neck of the womb it is easy to see how this may cause 
pain by interfering with the dilation of the mouth of 
the womb — a condition that must take place before 
the birth can occur. In its natural state the circular 
muscular fibres that exist here are capable of great 
distention, but when rendered inelastic by the products 
of inflammation the dilation is intensely painful and 
may rupture the fibres. 

The employment of caustics and incisions in the 
neck of the womb for the cure of disease or removal 
of strictures is apt to be followed by cicatrices which, 
being inelastic, are liable to unequal dilation and an 
increase of pain. Necessary as these practices may be 
they are certainly open to this objection, high authori- 
ties to the contrary notwithstanding. Anyone having 
a scar or cicatrix on their person knows that it will 
not stretch like other tissues and is often very sensi- 
tive. Some writers have labored hard to prove that 
the tissues of the uterus were not subject to the same 
laws as tissues in other parts of the body and, conse- 
quently, the results of inflammation, caustics and inci- 
sions would not affect the womb unfavorably, but it 
is certainly presuming very much upon the healing 
power of nature, to say the least. 

Any cause that can render any part of the generative 
apparatus sore, sensitive and tender, whether inflam- 
mation, ulceration, swellings, common leucorrhoea, 
diseases of the bladder, piles and, in fact, anything 
that impairs the integrity of any tissue, whether of 
the generative organs themselves or adjacent struc- 
tures, necessarily increases the suffering at the time 
of birth. Undue dryness of the passages may also be 







Figure 2 

The Muscular System 

1 and 2, muscles of upper part and side of head; 3, muscles of the eye; 4, muscles 
of the mouth; 5, muscles of the side of the face; 6, muscles of the side of the neck; 
8, muscles of the breast; 9, muscles of the shoulder; 10 and 11, muscles of the upper 
arm; 12-19 muscles of the forearm; 17, avicular ligament of wrist; 18, 19, 20, mus- 
cles forming front and sides of abdomen; 21, hip muscles; 22, 23, 24, muscles of 
front and outer side of thigh; 28, 29, 30, muscles of inner side of thigh; 25, 26, mus- 
cles of outer side of leg; 31, 32, muscles of inner side of leg; 27, bandlike ligament 
of ankle. 



46 PAINLESS CHILDBIRTH 

considered a cause, and can usually be overcome by 
artificial means. Any emollient or unirritating oily 
substance applied freely will answer. 

Anything that increases morbid irritability increases 
the suffering, which may be rendered intensely acute 
even though not the slightest change of structure be 
visible. This increased sensibility is probably due to 
some change in the nerves themselves which, in the 
present state of pathology, we are not able to appre- 
ciate. One thing, however, is certain; that morbid 
irritability is a concomitant of exhaustion, and if the 
nervous system has been debilitated and irritated by 
masturbation or sexual excesses an increase of suffer- 
ing will be pretty likely to occur. 

Rigidity of the perineal muscles is apt to cause pain 
in the latter stages of the labor. Sometimes the rigid- 
ity is so great that the perineum will rupture instead 
of relax, for the prevention of which slight superficial 
incisions have been recommended. In this condition, 
anaesthetics are beneficial and so are relaxants, if the 
management previous to this time has not been proper 
or effectual. (See subsequent chapters.) 

From the time when labor begins until it terminates 
there is usually more or less continuous suffering of 
variable intensity, so that speedy delivery is desirable 
as a means of ending the suffering. The labor, however, 
should not be so short as to occasion the dangers al- 
luded to in a previous chapter. 

The condition of the child as a cause of pain remains 
to be considered and is of the very greatest importance, 
because we have it in our power to control the condi- 
tion of which we are about to speak without danger or 
detriment to the child or mother. 



CAUSES OF PAIN 47 

The average weight of the newly-born child is said 
to be seven pounds — some are considerably smaller, 
others much larger. I have seen children live and thrive 
that did not exceed five pounds, and I have been present 
at several confinements when the child's weight ex- 
ceeded ten pounds, and one instance when the child 
weighed fifteen pounds. Births are said to have oc- 
curred w T hen the child has weighed eighteen pounds, 
but such instances are exceedingly rare and must cer- 
tainly be difficult and painful. The reasons are obvious. 

Beyond a certain size, as the weight of the child 
increases under ordinary circumstances, the pain and 
difficulty of the labor increases. Dropsy of the head 
increases the trouble. Wherever the head will pass, 
if there is no deformity, the rest of the body will pass, 
the passage of the foetal head always being the most 
difficult and painful part of the entire process of partu- 
rition. The larger the child, of course, the larger the 
head will naturally be, so that it is a proper consid- 
eration to inquire how we may, with safety to both 
mother and child, control the growth of the child in 
utero, and we introduce the subject here because it 
has a direct bearing upon the suffering of the mother. 
It requires no argument to convince anyone that while 
a small child may be born with little or no difficulty 
or pain, the same mother may find it absolutely im- 
possible to give birth to a large child — to a child with 
a large head or a deformed child. 

We now come to consider the bony development 
of the child as a cause of pain and difficulty at child- 
birth. It is often a subject of remark that the formation 
of bone in the skulls of some infants at birth is not 




Figure 3 
The Skeleton and Outline of the Body 

1, skull; 2, lower jaw; 3, vertebrae of neck; 4, collar bone 
(clavicle); 5, shoulder joint; 6, breast bone (sternum); 8, 
humerus or bone of upper arm ; 9, ribs; 12, spinal column; 13, 
the radius or large bone of forearm ; 14, the ulna or small bone 
of forearm; 15, the hip bone; 16, lower part of spinal column; 
17, hip joint with its ligaments; 18, the femur or thigh bone; 
19, the knee cap or patella; 20 and 21, the knee joints with their 
ligaments; 22 and 24, fibula, or small bone of leg; 23, tibia, or 
large bone of leg; 25, 26 and 27, ligaments of ankle and feet. 



CAUSES OF PAIN 49 

nearly as far advanced as in others, and yet such chil- 
dren thrive equally well. 

At birth the bones of the cranium have not been 
united by the ossific process, but admit of considerable 
mobility, so that by pressure the shape of the head may 
be materially changed, temporarily, without injury. 
Applying these observations to the transit of the child 
through the maternal passages, and we speedily arrive 
at the conclusion that the softer, more spongy, cartila- 
ginous these bones are at birth the more compressible 
the head will be and the more readily it will adapt 
itself to the passage, changing according to the neces* 
sity, while if the process of ossification — bony develop- 
ment — is well advanced, such adaptability cannot take 
place, the labor will be more difficult, greater pressure 
will be necessary and more pain experienced. 

Everybody is well aware that a soft body or sub- 
stance the same size as a hard one will readily pass 
through an opening or tube through which the hard 
body cannot pass at all or only with great difficulty. 

In the early stage of development, bones are soft 
and flexible, being composed of animal matter (gristle) 
but gradually become hard by the deposits of calca- 
reous matter (lime) within their structure. All bones 
do not undergo this hardening process simultaneously, 
but it is completed in different bones at different periods 
of life. There seems to be no good reason why thejbony 
system should have progressed beyond the cartila- 
ginous stage of development at birth, for there is plenty 
of time after this event for osseous development before 
any very great necessity for the presence of bone will 
be experienced by the child. 



50 PAINLESS CHILDBIRTH 

It is a well-established fact in physiology and thera- 
peutics that when bony development is tardy and the 
bones are incapable of supporting the weight of the 
body, protecting its cavities or preserving its symme- 
try, even when the process of teething is delayed, the 
administration of some of the preparations of lime as 
a medicine or the selection of a diet containing consid- 
erable lime is productive of good results. The lime 
administered artificially as medicine or naturally as a 
food supplies the deficient constructive element, and 
the development of bones goes on to completion. This 
being the case the questions naturally arise: 

If we can increase the supply of bone-producing 
material when deficient, can we not diminish it if 
excessive? 

If we can hasten development, can we not retard it? 

If we can retard it after birth, can we not before birth? 

If we can retard ossification before birth, then why 
can we not absolutely control the condition of the 
child's head and keep the bones sufficiently flexible 
to admit of easy delivery? 

All these queries can be answered in the affirmative. 
Experiment has proven that such results are not only 
possible, but that they are safe and practicable. 

Nervous excitement may be a cause of pain. It is 
well known that some persons suffer far more from the 
same cause than others, and it is reasonable to suppose 
that the more nervous the woman is during gestation 
and delivery the more intensely she will suffer. It is 
those who lead artificial lives or those whose consti- 
tutions have been shattered by disease that are troubled 
with "nervousness" and, if no precautions are taken, 



CAUSES OF PAIN 51 

it is reasonable to expect that such persons will suffer 
most at childbirth. 

Having briefly considered the most important causes 
of pain, in the subsequent chapters we shall endeavor 
to instruct the reader how to render these causes in- 
operative and to remove the parturient female from 
their influence. 



CHAPTER V 



CONCEPTION AND PREGNANCY 

The union of the male generative element — the 
spermatozoid — with the matured female ovum or egg 
is known as conception, fecundation, fertilization, im- 
pregnation. In the ovum as soon as fertilization occurs 
there begins a series of wonderful changes that result 
in the formation of a new being — the baby; every 
organ and tissue of the expectant mother is also grad- 
ually prepared for the new duty of reproduction. The 
limits of our book will not allow a minute description 
of these changes and we must, therefore, content our- 
selves with a brief consideration of the most important 
ones. They will be most easily understood if taken up 
in the following order: 

1. The ovum (embryo, foetus). 

2. Local changes — uterus, breasts, abdomen. 

3. General changes — heart, blood, lungs, urine, 

stomach, weight, skin, nerves. 

Changes in the Ovum: 

First Month. — Starting as a tiny, gelatinous mass 
that can hardly be seen with the naked eye, the 
ovum at the end of the first month is about the 
size of a pigeon's egg. (Fig. 3) 



CONCEPTION AND PREGNANCY 



53 



Second Month. — The ovum is as large as a hen's 
egg, and the embryo or foetus about l^ inches 
long. The eyes look like small black specks on 
the side of the head, and the limbs like little buds 
projecting from the body. 




Figure 4 

Semi-diagrammatic section of gravid uterus, showing con- 
tained ovum of about five weeks. 1, muscular wall of womb ; 
2, cavity of womb ; 3, wall of womb ; 4, cavity of womb ; 5, neck 
of womb. 

Third Month. — The ovum is about the size of a goose 
eggj the foetus 3 to 3J^ inches long. The placenta 
has formed and the cord is about 3 inches long. 

Fourth Month. — Length 5 to 6 inches; weight 4 to 
6 ounces. Hair appears on the scalp and scale- 
like nails on the fingers and toes. The sex can be 



,?s 



& 




^~~, 






I 









£ f--r"^^^ % 




Figure 5 

Early human embryos, all enlarged about two and one half times. 1-4 
from twelfth to fifteenth day; 5, 6, from eighteenth to twenty-first day; 7, 8, 
from twenty-third to twenty-fifth day; 9-12, from twenty-seventh to thirtieth 
day; .13-17, from thirty-first to thirty-fourth day; am, amnion; uv, umbilical 
or vitelline vesicle; als, allantoic or abdominal stalk; c c, brain vesicles; h, 
heart; va, visceral arches; o, optio vesicle; ot, optic vesicle; ol, olfactory pit; 
I, I, upper and lower extremities; s, somites; cd, caudal process; u, primitive 
umbilical cord. 



CONCEPTION AND PREGNANCY 56 

distinguished by the middle of the fourth month. 
The muscles have sufficiently developed to cause 
slight movements of the limbs (foetal movements, 
quickening). 

Fifth Month. — Length about 10 inches; weight 10 
ounces. The whole body is covered with fine, soft 
hair (lanugo) and the skin coated with a greasy 
substance known as vernix caseosa. A child born 
at the end of the fifth month may breathe and cry 
and move its limbs, but usually dies in a few hours. 

Sixth Month. — Length 12 inches; weight 1 pound. 
Eyelashes and eyebrows have started to form; 
skin is very wrinkled. If born at the end of the 
sixth month the child may live for a few days, 
but usually dies within a very short time. 

Seventh Month. — Length 15 inches; weight 3 to 
4 pounds. This is known as the viable age, because 
it is generally held that a child born before this 
time cannot survive. But with the aid of the 
incubator and scientific artificial feeding we are 
now able to save the lives of many babies born 
even earlier than this. 

Eighth Month. — Length 16 inches; weight 4 to 5 
pounds. An eighth-month baby is usually weaker, 
less active and more drowsy than a full-term child 
and, therefore, requires greater care and attention. 

Ninth Month. — The full-term baby weighs on the 
average from 6 to 7 pounds and measures about 
20 inches in length. The body is plump, the hair 
on the scalp 1 to 2 inches long, the eyes usually 
of a dark steel gray color, the finger nails' extend 
beyond the finger tips, Very soon after its entrance 



56 



PAINLESS CHILDBIRTH 



into the world the child, by loud and lusty cries 
and active movements of the limbs, announces its 
arrival and shows that it is very much alive. 

ATTITUDE OR POSITION OF CHILD IN THE WOMB 

During its life in the womb the child lies head down- 
ward (Fig. 4), the body curved, the chin bent upon 
the breast, the forearms crossed in front of the chest, 
the legs flexed on the thighs and the thighs drawn up 
on the abdomen. In the space thus formed between 




Figure 6 
Semi-diagrammatic section of uterus, showing relations of 
foetal and maternal placenta. 1, muscular wall of womb; 2, 
placenta (afterbirth); 3, cord; 4, bag of waters; 5, neck of 
womb. 

the legs and arms the cord containing the bloodvessels 
that carry food and life-giving blood to the develop- 
ing child is placed so that it may be out of harm's 
way and not pressed upon or otherwise injured. 



CONCEPTION AND PREGNANCY 57 

Boy babies are as a rule heavier and longer than 
girls. Ten-pound babies are uncommon and twelve- 
pounders rare, notwithstanding many reports to the 
contrary. It is, however, recorded that Mrs. Captain 
Bates, a Nova Scotian giantess, gave birth to a child 
(still-born) that weighed 23% pounds. 

A mother's first child usually weighs less than those 
she bears subsequently. Mothers between 30 and 35 
years of age have the heaviest children — young mothers 
the smallest and lightest. 

LOCAL CHANGES 

a. The Uterus. 

From a small, pear-shaped organ about 2 3^ inches 
long and one ounce in weight the uterus or womb at 
the end of pregnancy has grown to be a big, muscular 
sac, 12 to 15 inches long and weighing about 2 pounds. 
Every element that goes to make up the structure of 
the womb takes part in this growth. The bloodvessels, 
nerves, lymphatics and mucus membranes become 
bigger and larger, and the muscular fibres are so in- 
creased in both size and number that at the time of 
childbirth the womb has become such a strong, powerful 
organ that it is able by the contractions of its muscles 
to expel both child and afterbirth easily and gently, 
just as nature intended. 

b. The Breasts. 

During pregnancy the breasts are prepared by 
Mother Nature for the very important duty they must 
perform after the baby comes into the world. A feeling 
of uneasiness or fullness of the breasts, with a little 
tenderness of the nipples is experienced by some women 
almost at the very start of pregnancy. The breasts 
begin to enlarge in the second month and grow steadily 



58 PAINLESS CHILDBIRTH 




Figure 7 

until the end of gestation. The nipples, unless flattened 
as a result of tight corsets or other pressure, become 
larger and more prominent and often covered with 
small, branny scales. The areola or pigmented ring 
around the nipple becomes darker in color,, the shade 
or tint varying according to the woman's complexion 
from a light brown in blondes to a deep black in bru- 
nettes. The areola also becomes moist and slightly 
raised and on its surface are seen from ten to twenty 
glands — the glands of Montgomery — that look like 
little seeds under the skin. In some women at about 
the fifth month there appears on the edge of the areola 
a row of round spots lighter in color than the surround- 
ing skin; this is called the secondary areola. As the 
breasts become fuller and larger, reddish, bluish or 
whitish lines form in the skin — these are the lineae 
abicantes or striae and are exactly similar to those 



CONCEPTION AND PREGNANCY 59 



found on the abdomen of pregnant women. The blue 
veins can be easily seen coursing through the skin, and 
when they are big and tortuous are declared by many 
to prophesy an abundant supply of milk. In the last 
few weeks of pregnancy the breasts often droop a 
little, so as to be better adapted for suckling. In many 
cases even as early as the third month it is possible to 
press or squeeze from the breasts a little mucoid fluid 
known as colostrum. The presence of this fluid in the 
breasts is often a very valuable sign in the diagnosis 
of pregnancy. 

c. The Abdomen, Pelvic Cartilages and Navel. 

In the later weeks of pregnancy, reddish or bluish 
streaks — striae gravidarum — are found in the skin of 
the abdomen. They are due simply to stretching of 
the skin and may also result from tumors, dropsy and 
other causes. They last for quite a while after preg- 
nancy, but gradually become whiter and look like scars. 

d. The Cartilages between the bones of the pelvis 
become thicker and softer to allow them to spread and 
expand at the time of delivery. 

The navel at the end of pregnancy is prominent and 
elevated. 

GENERAL CHANGES 

Though pregnancy is a normal physiological process, 
almost every organ and tissue of the woman's body 
undergoes changes, because she must now provide 
nutriment, breathe, excrete and secrete not only for 
herself but also for her unborn babe. 

a. The heart becomes slightly enlarged and the 
pulse more rapid. More blood is formed and it coagu- 
lates or clots more readily — a wise precaution of nature 
to prevent unnecessary hemorrhage at confinement. 



60 PAINLESS CHILDBIRTH 

b. The shortness of breath so distressing to many 
pregnant women is caused by the enlarged and growing 
uterus preventing full expansion of the lungs. In the 
last two or three weeks the child settles — lightening — 
and breathing becomes freer and easier. 

c. A greater quantity of urine is passed and it often 
contains traces of sugar or albumen. During pregnancy 
the urine should be frequently examined chemically 
and microscopically by a physician. 

d. To sustain her own strength and to provide 
nutriment for the developing child the pregnant woman 
requires more and better food than at other times. In 
the early part the appetite may be capricious and the 
stomach irritable, but later on as a rule both appetite 
and digestion become better and the general condition 
greatly improved. 

e. Notwithstanding the nausea and vomiting there 
is usually a gain of about ten pounds in weight during 
pregnancy. 

/. The darkening of the areolae of the breasts 
during pregnancy has been described on page 58. Simi- 
lar pigmentations, usually most marked in dark-haired 
women, are found in many other parts of the body — 
the face, abdomen, armpits, navel. Dark rings under 
the eyes are common and the face is often marked with 
patches or blotches of pigment of all sizes and shapes; 
these are popularly known as moth patches or liver 
spots and technically as chloasma. Occasionally the 
greater part of the face becomes discolored — the so- 
called mask of pregnancy. The discolorations of the 
skin usually fade after confinement, but do not always 
entirely disappear. 



CONCEPTION AND PREGNANCY 61 

g. The whole nervous system of the pregnant woman 
is in a state of tension and the nerves are more sensi- 
tive and excitable. No two women feel the same whilst 
carrying a child, and we meet with every grade from 
the deepest depression to the highest exhilaration. 
Some women say that they feel better, healthier and 
happier during pregnancy than at any other time. In 
others, however, the whole character is changed, so 
that a woman of a bright, kind and lovable disposition 
becomes irritable, fretful, peevish, jealous and even 
despondent. Neuralgia, especially of the face and teeth, 
fainting spells, dizziness and hysterical outbreaks are 
quite common, but should not cause unnecessary worry, 
as they usually are purely functional in character and 
disappear quickly after confinement. 

FALSE OR SPURIOUS PREGNANCY 

This is a peculiar condition that occasionally occurs 
in nervous, hysterical women about the time of the 
change of life, and in single women who have been ex- 
posed to possible conception. Such cases at times are 
very deceiving, because many of the ordinary symptoms 
of pregnancy may be present. Menstruation may cease, 
the abdomen enlarge, sensations like foetal move- 
ments be felt, the breasts enlarge and milk form in 
them, vomiting and morning sickness may occur. In 
addition to that, such a woman at the end of what she 
has believed to be pregnancy may have all the symp- 
toms of labor itself — but no child. To remove all 
doubt and satisfactorily clear up such a case the physi- 
cian must carefully study and consider the objective 
symptoms and not rely upon statements made by the 
woman herself or by others. 



62 PAINLESS CHILDBIRTH 

HOW TO FORETELL THE DATE OF CONFINEMENT 
Every pregnant 'woman is naturally anxious to learn 
just when to expect her baby. To aid her in making 
such calculation several methods have been devised by 
means of which she can with a fair degree of accuracy 
foretell the date of her coming confinement. We will 
describe three methods: 

1. Put down the date of the first day of the last 
menstruation. From this date count nine months for- 
ward or, what is the same thing, three months back- 
ward, and add seven days to the date thus obtained. 
For example, suppose the last menstrual period 
came on January 5th. By counting nine months ahead 
or three months back you get October 5th. Now add 
seven days and you have October 12th as the probable 
date of confinement. 

2. Quickening usually occurs at four to four and a 
half months. If then you count forward four and a 
half or five months from the date on which quickening 
or life was first felt you have approximately determined 
the time of the coming confinement. Quickening does 
not appear at the same fixed time in all women, and 
on that account this method is not always satisfactory. 
It is of special use in calculating the date in those cases 
where conception has occurred in nursing women, 
because in them menstruation is normally suspended 
and cannot, therefore, be used as a basis for calculation. 

3. The table given on page 63 is a simple and con- 
venient method. 



CONCEPTION AND PREGNANCY 



63 





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CHAPTER VI 



SIGNS AND SYMPTOMS OF PREGNANCY 

There are so very few positive symptoms of preg- 
nancy in the early months that it is sometimes quite 
difficult to decide whether a woman is or is not preg- 
nant — in fact, a positive diagnosis of pregnancy before 
the second month is almost impossible. 

The signs and symptoms of pregnancy are: 

1. Cessation of menstruation. 

In a woman previously regular, stoppage of the 
menses is the first symptom that leads her to suspect 
that she is pregnant. It is by no means a positive sign 
of pregnancy, because anaemia, taking cold, exhaus- 
tion, change of climate may account for the absence 
of the menses. Menstruation may recur for the first 
two or three months or regularly or irregularly during 
pregnancy. Many women become pregnant during 
lactation, though at such times menstruation is nor- 
mally absent, and conception has occurred in young 
girls before the menses appeared and in women who 
had passed the change of life. 

2. Irritability of the bladder. 



SIGXS AND SYMPTOMS OF PREGNANCY 65 

The pressure of the growing womb upon the bladder 
often causes in the early weeks of pregnancy an almost 
constant desire to void urine. Many women consider 
this to be an early and sure sign of pregnancy. It is, 
however, by no means reliable, since it may result from 
many causes other than pregnancy. 

3. Changes in the breasts and nipples. 
These have been described on pp. 57-59. 

4. Morning sickness, nausea and vomiting of preg- 
nancy — salivation. 

This is usually an early symptom of pregnancy, and 
Whilst in most women it is a comparatively mild ail- 
ment, in others the vomiting may be so severe and 
persistent as to seriously affect the health. It often 
occurs immediately after conception has taken place, 
but as a rule it first appears about the fifth or sixth 
week and lasts until the time of quickening (fourth 
month). Occasionally it continues through the whole 
pregnant period and in some cases it disappears after 
the first few weeks, to reappear during the last few 
weeks. 

It is usually first felt when the head is raised from the 
pillow or on getting out of bed in the morning, and 
varies from a slight nausea or the spitting up of a 
little frothy mucus to actual vomiting (possibly with 
retching) of sour, bitter fluids or food itself. Sometimes 
the nausea lasts throughout the day and is often made 
worse by eating or even seeing or smelling food and 
by sexual excesses. Nausea or vomiting is apt to be 
a marked symptom in the first pregnancy of nervous 
women. 

Singular as it may seem, well-authenticated cases 



66 PAINLESS CHILDBIRTH 

have occurred in which the husband experienced the 
morning sickness instead of the wife. 

In the severe cases of morning sickness there is apt 
to be an increased amount of saliva (cotton spitting) , 
even to the extent of constant dribbling from the mouth. 

Considered alone, morning sickness is just a suspi- 
cious symptom of pregnancy, but when added to other 
symptoms the probability of pregnancy existing is 
greatly increased. 

5. Enlargement of the abdomen. 

In the first two months of pregnancy the abdomen 
is flatter than usual, because the uterus, now heavier 
than usual, sinks or settles down in the pelvis. In the 
fourth month the uterus can be felt as a smooth, round 
swelling in the lower part of the abdomen. (See Figure 8. ) 
At the sixth month the top of the enlarged uterus 
is on a level with the navel; in the seventh month it 
is two inches higher; in the ninth month it has reached 
the edge of the ribs. 

The enlargement may, of course, be due to a tumor, 
but when it is possible to palpate the child or detect 
the foetal movements it becomes a positive sign of 
pregnancy. 

6. Softening of the neck of the womb. 

This sign can often be detected by a skillful hand 
about the middle of the second month. An old rule 
but a good one says: "If the mouth of the womb feels 
as hard as the tip of the nose the woman is not pregnant, 
but if as soft as the lips she is pregnant. " This is a 
valuable sign of pregnancy, especially when associated 
with other symptoms. 



SIGNS AND SYMPTOMS OF PREGNANCY 



67 



7. Quickening — Foetal movements. 
The term "quickening" arose from the erroneous 
belief that it was not until the child moved that it 




9th month 
- 7th month 

«• 6th month 
/ *■ 5th month 
*- 4th month 



Figure 8 

The size and height of the womb in successive months of 
pregnancy. The numbers indicate weeks. 

became quick or alive. Foetal movements or quicken- 
ing are usually first felt by the mother about the middle 



68 PAINLESS CHILDBIRTH 

of the fourth month, but the exact time varies greatly 
in different women. But even earlier than this some 
women have peculiar sensations described as fluttering, 
creeping or pulsating and called by them " feeling life. ^ 
Faintness or other unpleasant nervous symptoms are 
very liable to occur when the movements are first felt, 
especially in a young, nervous woman in her first preg- 
nancy. The force and frequency of the movements 
vary not only during pregnancy, but also in different 
women. At times they are so strong and violent as to 
cause actual suffering to the woman; in others they are 
absent or so weak and feeble that doubts may arise 
as to whether the child is living or dead. To the physi- 
cian foetal movements constitute a valuable and posi- 
tive sign of pregnancy. 

8. Fcetal heart sounds. 

The beats or pulsations of the heart of the baby in 
the womb can be heard any time after the middle of 
the fifth month by the trained ear of the skillful physi- 
cian through an instrument called the stethoscope. 
It is an absolute and positive sign of pregnancy, and 
because the heart beats slower in boys than in girls 
it is by many considered possible by this means to 
predict the sex of the child before birth. 

Ballotement, Hegar's sign, Braxton Hick's con- 
tractions, uterine murmurs, are other positive and 
absolute signs of pregnancy, but are so scientific and 
technical that they are quite beyond the scope of our 
book and hence the mere mention of them must suffice. 

Symptoms that indicate death of the foetus : 

When the child or foetus dies while still in the womb 
the woman's health deteriorates, she suffers from chilly 
sensations and a heaviness or feeling of weight in the 



SIGNS AND SYMPTOMS OF PREGNANCY 69 

abdomen; she no longer feels life or movements; the 
womb ceases to grow and the breasts become shrunken, 
soft and flabby. In addition to those symptoms the 
physician, even after repeated examinations, cannot 
hear the foetal heart sounds or recognize any move- 
ment of the child. 

Plural births — twins — triplets, etc. : 

Twins occur once in about eighty-five cases, triplets 
once in about seventy-five hundred. A few quadruplets 
are born and there are recorded about a dozen cases 
of five at a birth. Certain women are more likely to 
bear twins than others; this tendency may be heredi- 
tary and at times is almost a family characteristic. 
The chances of twins are greatest in women who have 
previously born children, but also strong in the first 
pregnancy of women who marry late in life. In twin 
births a boy and a girl is the most frequent combina- 
tion, next two girls, then two boys. 

Twins and triplets are usually smaller and weaker 
than other children, and one may be larger than the 
others. 



CHAPTER VII 



HYGIENIC MANAGEMENT 

The object of hygiene is to secure the most perfect 
health possible and prevent sickness. To this end it 
may be necessary to place certain restrictions upon 
our customary habits. We say restrictions, because 
many of the habits we may have developed by artifi- 
cial modes of life are apt to be inconsistent with per- 
fect physical development. 

The special object in introducing the subject here 
is to secure for the mother the most perfect physical 
standard and, at the same time, endow her unborn 
child with a perfect constitution. 

The pregnant woman should avail herself of every 
possible means to improve her physical health and 
avoid every influence that can possibly fret, annoy, 
distress or in any way injure her. 

The husband and those who habitually must asso- 
ciate with her should endeavor to preserve the tran- 
quility of her mind, remove all sources of anxiety, 
relieve all annoyances and by every possible means 
contribute to her vigor, cheerfulness and happiness. 
Her associations should be of the most cheerful, pleas- 
ant, graceful and happy character, so as to remove 



HYGIENIC MANAGEMENT 71 

from her mind gloomy forebodings, anxiety, fear and 
selfishness. She should never be surrounded with any 
imperfections, nor be annoyed with the contemplation 
of misery, deformity or unhappiness. She should never 
be compelled to hear stories of horror which Dame 
Grundy so much delights to tell. 

Before important surgical operations are performed, 
more or less time is generally spent in putting the 
patient in the most perfect physical condition possible, 
that the system may be better able to bear the shock 
of the operation, a change that will result in diminish- 
ing pain and danger and hasten recovery. If physical 
perfection is a matter of so much consequence under 
such circumstances how much more important is it 
when the welfare of two beings is at stake? 

If conception occurs while the woman is nursing 
another child it should be weaned at once, for her 
physical forces will rarely, if ever, enable her to main- 
tain both without impairing their vitality and injuring 
herself. 

EXERCISE 

The pregnant woman should not lead a life of indo- 
lence, nor should she, on the other hand, indulge in 
prolonged or violent exercise. Much must depend upon 
the natural vigor she possesses. 

Owing to the extreme liability of some women to 
miscarriage they will find it necessary to avoid motion 
almost entirely. This no doubt proceeds from some 
local weakness or irritability that is aggravated by 
motion. Fortunately, such cases are rare, and the best 
treatment is quiet, with passive motion. This condi- 
tion frequently disappears after a certain period of 
gestation has been reached. 



72 PAINLESS CHILDBIRTH 

With this rare exception exercise is always benefi- 
cial if moderately indulged and is most beneficial when 
carried on in the open air, but should never, under any 
circumstances, be so active or long continued as to 
induce fatigue. Probably walking is the best form of 
exercise that can be taken, although when the preg- 
nancy is far advanced it may become so difficult and 
painful that it may be omitted. When for any reason 
walking is not advisable, riding in an easy carriage may 
be substituted. 

No matter whether she is to walk or ride, care should 
be taken that it is agreeable and pleasant. There should 
be some agreeable, animating object in view. The 
woman must not be made to realize that the walk or 
ride is a forced routine. The mind as well as the muscles 
must be diverted, else the exercise becomes monotonous 
and tiresome — a damage instead of a benefit. The 
same road or path should not be selected each day; the 
mind is to be occupied by new attractions; a variation 
of scenery and circumstances. The exercise should be 
frequently repeated and not too long continued and 
should be carried on in the open air in the sunshine. 

By exercising in the forenoon we get the use of the 
best physical strength and at a time when every organ 
is in the best condition to profit by it. It is then that 
exercise is a pleasure. In the morning, exercise is apt 
to refresh. In the afternoon it is liable to fatigue. In 
the forenoon we are most apt to have sunshine and 
the air is purest and most exhilarating. 

A gently active life is best calculated to preserve 
the health of the mother and her unborn child. The 
object is to increase and conserve the physical forces — 
to invigorate. Violent or prolonged exercise is to be 



HYGIENIC MANAGEMENT 73 

avoided. Running, dancing, rowing, lifting, carrying 
heavy weights, as well as riding in uncomfortable or 
uneasy carriages over rough roads or upon horseback 
are objectionable. Railway travel is unwise, the con- 
tinuous jar of the cars being equally as dangerous as 
violent jolting. 

The nearer delivery approaches, the more repose and 
quiet may be indulged. The use of the sewing machine 
should be discontinued. 

THE LIVING ROOMS 

Pure air and plenty of it is the rule, and not only 
should the exercise be taken out of doors as much as 
possible, but the air of the rooms she occupies should 
be free from impurities. The air should be frequently 
changed and is best done when the rooms are unoccu- 
pied. Give them frequent airings and avoid extremes 
of heat and cold. Perfect ventilation does not imply 
that the rooms are to be turned out of doors or the tem- 
perature reduced to the freezing point. A small opening 
at the top and bottom of the rooms will secure a con- 
stant change of air — a constant admission of oxygen 
and escape of carbonic acid gas — and yet the tempera- 
ture may be maintained at an agreeable pitch. It is 
a mistaken notion that cold air only is pure. 

The apartments do not want to be dark. Let in the 
rays of the sun; receive their vivifying influence. 
Plants will not thrive in the dark, and neither mother 
nor child can flourish without sunlight. Sun baths 
are decidedly beneficial. Sit in the sun half an hour 
or more daily. Feeble women will find it an agreeable 
tonic. 

BATHING 

Bathing is beneficial when properly employed, but 



74 PAINLESS CHILDBIRTH 

extremes must be avoided; there is no sense in soaking 
a person to death on the one hand nor completely 
obstructing the pores of the skin with dirt on the other. 
The temperature of the bath, the time of its employ- 
ment and the object to be attained must always be 
considered. 

It is folly to suppose the same kind of bathing will 
answer every purpose, for bathing implies something 
more than mere cleanliness; the temperature materi- 
ally influences the result; and while one woman may 
be greatly benefited by a cold bath another will be 
injured by it. Those who have an abundance of vital- 
ity will find the cool or even cold bath beneficial and 
agreeable, while those of a feeble constitution may be 
so chilled and injured by it that, reaction failing to 
occur, serious internal congestions and even fatal con- 
sequences may follow. 

As a rule, bathing should be agreeably tempered to 
suit, varying from cold to hot, partial or complete, 
plunge, tub, sponge, douche, sitz, etc. 

Probably the temperate or tepid bath will be suitable 
for the greatest number. Immediately after emerging 
from it the body should be rubbed thoroughly dry 
with a coarse towel, that proper reaction be induced. 
Usually the bath may be continued from three to ten 
minutes, and the lower the temperature the shorter 
duration. 

Cool baths are most beneficially employed in. the 
fore part of the day, the object being mainly to secure 
its invigorating effect, while the warm bath on account 
of its soothing, calming influences is most beneficial 
in the latter part of the day or evening. 

Women who have previously been in the habit of 



30° 


to 60° 


60° 


to 75° 


75° 


to 85° 


85° 


to 92° 


92° 


to 98° 


98° 


to 110° 



HYGIENIC MANAGEMENT 75 

cold, plunge or shower baths should not discontinue 
them now; but if they have never accustomed them- 
selves to them it is doubtful if it is best to begin them 
while in this condition, lest the shock they occasion 
cause miscarriage. 

The temperature of the different kinds of baths varies 
considerably, as w T ill be seen from table: 

Cold bath - -;:'..- - 30° to 60° Fahr. 

Cool bath - - 

Temperate bath - - 

Tepid bath - 

Warm bath - - 

Hot bath - - - 

Nervous women will find that a warm bath taken 
just before retiring will allay irritability, nervousness 
and induce agreeable sleep. It moderates pain and 
soothes the entire system; and if not continued too 
long will not debilitate, but rather invigorate. Bathing 
should not usually be indulged in while digestion is 
going on. 

Baths may be medicated or not, as desired. For 
the purpose of cleanliness, the tepid sponge bath is 
most available, though the sponge employed briskly 
in the morning, moderately cool and followed imme- 
diately by a brisk rubbing is to be recommended; and 
those who have not the facilities for immersing the 
whole body will find it an excellent way to apply the 
tepid or warm bath at night. 

THE SITZ BATH 

With reference to the employment of the sitz bath 
we cannot do better than quote from the well-known 
author, Dr. Shew: 

Pregnant women receive much benefit from a constant use of 
this bath. A small tub of sufficient size set upon a very low 



76 PAINLESS CHILDBIRTH 

stool or anything by which it can be raised a few inches is 
quite sufficient. Unpainted wood is the best material, metal 
being unpleasant and cold. The water is used from one to five 
or six inches deep. The length of time this bath is used varies 
from a few minutes to two hours or more. To avoid exposure 
to cold it is best to uncover only the part of the person to be 
exposed to water. This bath has the effect of strengthening 
the nerves, of drawing the blood and humors from the head, 
chest and abdomen, and of relieving pain and flatulency and is 
of the utmost value to those of sedentary habits. It is sometimes 
well to take a foot bath, tepid or cold, at the same time. If a large 
quantity of cold water were used in this bath it would remain 
cold too long, and thus drive the blood to the head and upper 
part of the body, which might be very injurious; but the small 
quantity of water used at once becomes warm and thus admits 
of speedy reaction. In some local diseases of the lower parts 
when there is inflammation and the cold water feels most agree- 
able the water is frequently changed. If there is any inclination 
to headache or too much heat in the head a cold bandage upon 
forehead and temples is good. It is often well to rub the abdo- 
men briskly during this bath. The sitz bath may be used by any 
person whether in health or otherwise without the slightest 
fear of taking cold. Let those subject to giddiness, headache or 
congestion of blood in the upper regions try this and they will 
at once perceive its utility. In those troublesome itchings which 
often afflict pregnant women this application may be made as 
often as the symptoms occur and will be found a sovereign 
remedy. 

It is not desirable that any shock should be given 
the system, and the temperature at which the bath 
is begun should usually be about that of the tepid bath. 
It can be employed at any time of day, and when taken 
in the evening is quite agreeable to those who do not 
use the warm general bath. 

SLEEP 

Plenty of refreshing sleep is essential to the welfare 
of both mother and child. At least eight hours is advis- 
able. It favors the tranquility of both mind and body 



HYGIENIC MANAGEMENT 77 

and not only relieves the uneasiness and inconvenience 
sometimes attending this condition, but is a potent 
preventive of habitual miscarriage. A regular hour 
for retiring is advisable and the sleeping room should 
be quiet and airy, neither too warm nor too cold; the 
bed moderately hard; the covering light but sufficient 
to prevent chilliness; mattresses of hair or other firm 
material are to be preferred and feathers prohibited. 
Occasionally a nap during the day is admissible and 
frequent rests desirable; but in resting it is not best 
to sit on cushions, for, by the warmth of the body they 
occasion, they induce congestion of the pelvis, a condi- 
tion particularly to be prevented. 

THE CLOTHING 

The dress should be loose and comfortable and so 
arranged that unequal pressure is avoided. It should 
be suspended from the shoulders instead of the waist 
and hips. Stays and corsets if worn at all must be loose 
enough to admit of perfect freedom of the abdominal 
muscles, and after the fifth month had better be laid 
aside. It would be better for all women if they would 
never wear corsets, for they impair the power of the 
muscles they surround. 

Any attempt to conceal her condition by lacing, stays 
or tight dresses cannot be too severely condemned 
and will be certain to be followed by bad results which, 
in many instances, will not admit of a remedy. The 
Spartan law directed that pregnant women should wear 
large dresses, so as not to prejudice the free develop- 
ment of the precious charges of which nature had 
rendered them the momentary depositories. 

In those women in whom the abdomen is un- 
usually bulging or pendulous much relief is obtained 



78 



PAINLESS CHILDBIRTH 



from wearing a properly fitting abdominal bandage. 

Care should be taken that the breasts are not pressed 
upon nor injured in any way. 

Flannel underclothing is always best, unless in the few 




Figure 9 

Position of the child and the womb in case of enlarged and 
pendulous abdomen, 
exceptional cases where the skin is exceedingly sensitive. 



HYGIENIC MANAGEMENT 79 

In no case should tight garters if indeed any be worn, 
on account of their tendency to obstruct the circu- 
lation and cause cold feet and the knotted condition 
of veins that give so much trouble subsequently. 

SEXUAL RELATIONS 

In many pregnant women considerable pain in the 
lower abdomen and even abortion result from sexual 
intercourse; when too freely indulged in it exhausts 
the mother and impairs the vitality of the child. The 
greatest moderation should therefore be observed. The 
mind should be kept free from the subject and every 
circumstance that has a tendency to promote desire 
should be studiously avoided. In the early months 
(first two or three) when so many abortions occur 
and in women who easily abort or in whom symptoms 
of threatening miscarriage are present, and also in the 
later weeks of pregnancy, separate beds and even 
separate sleeping rooms are to be recommended. On 
the other hand, ungratified desires, where so great as 
to gain control of the mind, are liable to mark the foetus 
with an insatiable appetite. It is for this reason we 
counsel moderation and believe the moderate gratifi- 
cation of any appetite when consistent with reason is 
better than absolute denial. Temperance is the best 
conservator of health and pleasure. 

MATERNAL IMPRESSIONS— MOTHERS' MARKS 

Although there is a great diversity of opinion about 
how mothers' marks are produced, yet the very fact 
that they do exist is evidence that there must be some 
cause. We will, no doubt, always be confronted with 
instances in which these marks cannot be traced to 
any assignable cause and, on the other hand, "assign- 
able causes" will have proved inoperative. 



80 PAINLESS CHILDBIRTH 

Some writers have urged that there is no nervous 
communication between the mother and child. While 
we will not debate this point we are certain there is a 
direct communication through the blood, which is 
sufficient, were we to leave " sympathy " entirely out 
of the question, and if one quality may be transmitted 
through this medium why may not others? 

No one will attempt to deny that during pregnancy 
the mother is unusually susceptible to external im- 
pressions; and in view of the accumulated evidence 
we regard it safe to state that any external circum- 
stance that is capable of making a profound or prolonged 
impression on the mother may, through the blood or 
sympathy, affect the child in utero. 

We might bring forward numerous instances to sub- 
stantiate our views, but we regard them as entirely 
unnecessary. Every neighborhood has its examples. 
The prospective being is really a part of the mother 
herself and will be subject to a very great extent at 
least to the same influences. 

The impressions or marks on the child vary from 
the smallest naevi (mothers' marks) to the greatest 
physical or mental deformity. The whole subject, 
however, is still in the world of speculation and theory, 
and we must therefore content ourselves with the facts 
given in the preceding paragraphs. 

A practical conclusion suggested by this considera- 
tion is to remove the prospective mother as far as 
possible from the operation of those influences that 
may make unfavorable impressions upon the fragile 
structure of the unborn, and surround her with such 
influences as create a healthful, cheerful and agreeable 
state of mind. This should be remembered by husband, 



HYGIENIC MANAGEMENT 81 

attendants, associates and all who are brought in con- 
tact with her. The mind should be agreeably occupied — 
refinement, pure emotions, noble sentiments, equanim- 
ity should be cultivated, together with everything that 
contributes to good nature, enjoyment and serenity. 

Avoid the presence of unsightly and disagreeable 
objects and as quickly and quietly as possible divert 
the mind from them. Gratify unnatural "longings" as 
far as is consistent with reason and circumstances and 
thus terminate their influence. Do not worry yourself 
about something you can not help, nor anticipate 
trouble that may never come to pass. Cultivate control 
over the will. Dismiss unpleasant thoughts and un- 
reasonable fancies as quickly as possible; think of 
something else; do not listen to the horrible and terri- 
fying stories which neighboring gossips delight to 
tell, nor be kept in a state of terror and anxiety about 
the termination of the conception by the yarns of 
those meddlesome old grannies who are always ac- 
quainted with some case that was just like yours 
and something happened. 

Every community is unfortunately cursed by such 
busybodies. Heed them not; they are no more capable 
of judging of your condition or predicting the future 
than they are to be President, and their tales are nearly 
always imaginary. 

Contemplate grace and beauty, and by such a course 
you will not only be likely to avoid mothers' marks, but 
to beget healthful, talented, beautiful children. Culti- 
vation of mental qualities is worthy an effort. If it 
is desired that the unborn excel in some branch of 
learning or profession let the mother exercise her mind 



82 PAINLESS CHILDBIRTH 

in that direction. In a word, keep the mind free from 
unpleasant subjects, unhappiness, anxiety, anger, etc., 
but filled with agreeable fancies and charming images. 
Cultivate graceful attitudes, remembering that her 
course now must be reflected in the future character of 
her unborn babe. The ancient Greeks surrounded 
pregnant women with statuary, paintings and engrav- 
ings, and with good results. 

DETERMINATION OF SEX— CAUSE OF SEX OF CHILD 

Is there any way by which one sex can be produced 
in preference to the other? In other words, can a boy 
or girl be produced as the parents may wish? From 
the oldest times scientists have tried to discover means 
to accomplish such a result. Many ways have been 
suggested, but none have stood the test. All are but 
mere theories that further experience has shown to 
be wrong or even absurd. One theory held that con- 
ception occurring just before the menstrual period pro- 
duced a boy, but after the period a girl. Schenk claimed 
that sex depends upon the nutrition of the mother and 
the state of her blood — that in a woman abundantly 
nourished during the first four months and in whom 
the blood is made rich and red the chances are strongly 
in favor of a girl baby, and vice versa. 

Science has not yet solved the problem as to what 
causes the sex, and the question must therefore for 
the present remain as one of nature's hidden secrets. 



CHAPTER VIII 



DIETETIC MEASURES 

Since the composition of different kinds of food 
has been determined by chemical analysis the influ- 
ence of diet upon physical conditions is capable of 
comprehension, and there no longer remains any doubt 
of the importance of a well-selected diet in pregnancy. 
It has been proved that at least some of the unpleasant 
phenomena attending this condition can be overcome 
or avoided by a properly regulated diet. 

We have already had occasion to allude to the influ- 
ence bony development of the foetus exerts upon the 
ease or difficulty of childbirth, and it is now appro- 
priate that we consider the relation of diet to bony or 
osseous development. It is well known to physiolo- 
gists that the various structures of the body are elabo- 
rated from the materials supplied by the food, and that 
if certain nutritive elements are deficient those struc- 
tures into the composition of which they enter must 
necessarily be defective. 

Bones are composed very largely of calcareous or 
earthy matters, and the process of ossification is not 
completed in all the bones until the individual has 
reached adult life. 



84 PAINLESS CHILDBIRTH 

In the early stages of foetal life, what afterwards 
becomes bone is in a state closely resembling gristle, 
and it is not until several months have elapsed that 
the deposit of earthy matters takes place in this gristly 
substance, but so rapidly does it then take place that 
at birth some of the bones have acquired considerable 
hardness and thus preserve the form and shape of the 
child. This bony development, therefore, we desire 
to retard in order to render the birth easy; and as the 
earthy substances that form bone as well as the ma- 
terials that compose the other structures of the child 
must necessarily be derived from the blood of the 
mother, and her blood in its turn be supplied by her 
food, the question naturally presents itself: Why 
cannot the food of the mother be selected so that there 
shall be a sufficiency of all the nutrient materials except 
that which occasions the hardening of bones? 

So far as we know, this subject was first brought to 
public notice by an English chemist named Row- 
botham, by the publication of a small pamphlet in 
1841. This pamphlet is now out of print, but the prin- 
ciples it contained have been made the central idea of 
a treatise entitled, Parturition Without Pain, by M. 
L. Holbrook, M. D., to which very valuable little work 
I am greatly indebted for many important suggestions. 

Mr. Rowbotham's idea originated from reading the 
physiology of the development of the fcetus, from 
which he reasoned that the calcareous substances being 
deposited from the mother's blood, a diet deficient in 
this element would materially affect the character of 
the birth. His wife having suffered severely in two 
previous births he determined to try the experiment 
of a restricted diet with the hope of relieving her 



DIETETIC MEASURES 85 

suffering, and the result being so satisfactory he made 
it public in the pamphlet referred to above. 

She had, on this occasion, two years and a half after the last 
delivery, advanced full seven months in pregnancy before she 
commenced the experiment at her husband's earnest instance. 
Her legs and feet were, as before, considerably swelled, the veins 
distended and knotty and her health diminishing. 

She began the experiment in the first week of January, 1841. 
She commenced by eating an apple and an orange the first thing 
in the morning and again at night. This was continued for about 
four days, when she took just before breakfast in addition to 
the apple and orange the juice of a lemon mixed with sugar and 
at breakfast two or three roasted apples, taking a small quantity 
of her usual food, viz.: wheat en bread and butter. During the 
forenoon she took an orange or two and an apple. For dinner 
she took fish and flesh in small quantities and potatoes, 
greens and apples — the apples sometimes peeled and cut into 
pieces, sometimes boiled whole, along with potatoes, sometimes 
roasted before the fire and afterwards mixed with sugar. In the 
afternoon she sucked an orange or ate an apple or some grapes 
and always took some lemon juice mixed with sugar or treacle. 
At first the fruits acted strongly on the stomach and intestines, 
but this soon ceased and she could take several lemons without 
inconvenience. For supper she had again roasted apples or a few 
oranges, and rice or sago boiled in milk; sometimes the apples 
peeled and cored were boiled along with the rice and sago. On 
several occasions she took for supper apples and raisins or figs, 
with an orange cut among them, and all stewed together. Two 
or three times a week she took a teaspoonful of a mixture made 
of the juice of two oranges, one lemon, half a pound of grapes 
and a quarter of a pound of sugar or treacle. The sugar or treacle 
served mainly to cover the taste of the acids, but all saccharine 
matters are very nutritious. The object of giving these was to 
dissolve as much as possible the earthy or bony matter she had 
taken with her food during the first seven months of her 
pregnancy. 

She continued in this course for six weeks when, to her surprise 
and satisfaction, the swelled and prominent state of her veins 
which had existed before she began had entirely subsided; her 



86 PAINLESS CHILDBIRTH 

legs and feet which were also swelled considerably had returned 
to their former state and she became so light and active she could 
run up and down a flight of more than twenty stairs with more 
ease than usual when she was perfectly well. Her health became 
unwontedly excellent and scarcely an ache or a pain affected 
her up to the night of her delivery. Even her breasts which, at 
the time she commenced the experiment as well as during her 
former pregnancies were sore and tender, became entirely free 
from pain and remained in the very best condition after her 
delivery and during her nursing. 

At nine o' clock on the evening of March 3d after having cleaned 
her apartments she was in the adjoining yard shaking her own 
carpets, which she did with as much ease as anyone else could 
have done. At half-past ten she said she believed her time had 
come and the accoucher was sent for. At one o'clock the surgeon 
had left the room. He knew nothing of the experiment being 
made, but on being asked on paper by the husband two days 
afterward if he " could pronounce it as easy and safe a delivery 
as he generally met with," replied on paper: "I hereby testify 
that I attended Mrs. Rowbotham on the third instant and that 
she had a safe labor and more easy than I generally meet with. " 
On his asking the female midwife if she thought it as easy as 
usual, replied: "Why, I should say that a more easy labor I 
never witnessed; I never saw such a thing and I have seen a great 
many labors in my time." 

"The child — a boy — was finely proportioned and exceedingly 
soft, his bones were all in gristle, but he became of large size and 
very graceful, athletic and strong as he grew up. The diet of 
his mother was changed on his birth and she ate bread and milk 
and all articles of food in which phosphate of lime is found and 
which had been left out before. She also got up from her con- 
finement immediately and well. After her last delivery, in July, 
1838, full ten days elapsed before she could leave her bed and 
then she swooned at the first attempt. On this occasion, March, 
1841, she left her bed on the fourth day and not only washed but 
partly dressed herself. Had she not been influenced by custom 
and somewhat timid she might have done so sooner. To be 
assisted appeared like a burlesque to her, not to say annoyance. 
She had no assistance from medicine. In the former pregnancy 



DIETETIC MEASURES 87 

she had subsisted very much on bread, puddings, pies and all 
kinds of pastry, having an idea that solid food of this kind was 
necessary to support and nourish the fcetus, and it is quite right 
to suppose that nutritrious food is necessary for this purpose, 
but nutritious food can be had without that hard and bony 
matter which is so large an ingredient in wheaten flour. For 
instance, the West India grains, sago, tapioca, rice, etc., have 
little of it; and Mr. Rowbotham made a table of substances 
with the proportion of phosphate of lime in each so that it may 
be avoided in the food during pregnancy and used afterwards 
in nursing when the bones and teeth are made. Wheat contains 
most earthly matter. 

" Beans, rye, oats, barley, have not so much earthly matter as 
wheat; potatoes and peas not more than half as much; flesh of 
fowls and young animals, one-tenth; rice, sago, fish, eggs, etc., 
still less; cheese, one-twentieth; cabbage, savoy, brocoli, arti- 
chokes, coleworts, asparagus, endives, rhubarb, cauliflower, 
celery and fresh vegetables generally, turnips, carrots, onions, 
radishes, garlics, parsley, spinach, small salad, cucumbers, leeks, 
beets, parsnips, mangel-wurzels, mushrooms and all kinds of 
herbs and flowers average less than one-fifth; apples, pears, 
plums, cherries, strawberries, gooseberries, raspberries, cran- 
berries, blackberries, huckleberries, currants, melons, olives, 
peaches, apricots, pineapples, nectarines, pomegranates, dates, 
prunes, raisins, figs, lemons, limes, oranges and grapes, on an 
average, are two hundred times less ossifying than bread or any- 
thing else prepared of wheaten flour." 

. With such an extensive list of non-ossifying edibles 
to select a dietary from, and the culinary ingenuity 
of most women, it does not seem that the appetite 
for preparations of wheat would be very difficult to 
appease. A varied diet is absolutely essential to health, 
and an occasional meal of which wheat bread forms 
a part may be permitted, more particularly in the 
early months of gestation, but in the three latter months 
when ossification is going on, the more carefully the 
diet is selected to exclude phosphate of lime the better. 



88 PAINLESS CHILDBIRTH 

There is no danger of injury to the mother or child 
by this dietetic course, for it is impossible to exclude 
all calcareous matter, yet the quantity can be so dimin- 
ished as to retard instead of favor ossification. The list 
as quoted above may not be absolutely correct, yet 
as the fruits that are most advised contain so much 
acid that they probably hold the calcareous matters 
in solution and prevent their deposition, consequently 
the list is practical and the results satisfactory. 

As regards drinks, in many sections the water con- 
tains in solution considerable quantities of lime — the 
water is hard — consequently rain or snow waters are 
best. Boiling such hard water before using will cause 
the precipitation of considerable of the lime, as may 
be observed by the formation of the crusts in the tea- 
kettle. When it is necessary to use hard water it should 
be boiled and cooled before using for cooking or drink- 
ing. Tea and coffee may be moderately indulged in, 
and of the two tea is least objectionable. Cocoa contains 
less lime than coffee, though coffee is a good nutriment 
with this one exception. Lemonade or drinks made of 
acid fruits, jellies, etc., are unobjectionable, and the acids 
they contain will to a certain extent hold the earthy 
or calcareous bony matters in solution and oppose their 
deposition. 

Women living upon the foregoing diet will have 
little desire for much drink of any kind. 

Swelling of the feet and limbs rarely occurs when 
the fruit diet is employed, and cases suffering from 
such difficulty when the diet is begun will generally 
experience decided relief. 

There has been no objection offered to animal food. 
Indeed, we would advise that it form at least a small 



DIETETIC MEASURES 89 

portion of the diet, particularly in debilitated and 
feeble women, but in those of full habit it had better 
be sparingly eaten, as it is heating while the acid foods 
are cooling. Lamb, veal, chicken and fish are the most 
appropriate meats for this condition. 

Inordinate and capricious appetites for improper 
and noxious articles should, of course, be opposed, 
but when the longing can safely and properly be in- 
dulged it should be gratified. With the diet list advised 
very little if any annoyance is to be apprehended. 

The benefits to be secured by a well-regulated diet 
are not merely hypothetical, but have been fully sub- 
stantiated by experiment. Soon after the publication 
of the pamphlet referred to, an English lady of high 
respectability resolved to profit by the idea and as 
soon as she thought she was pregnant she abandoned 
bread, potatoes and milk and subsisted on the West 
Indian grains, rice, tapioca and sago, fruits of all kinds 
and vegetables and when she ate meat she ate that 
which was young, drank lemonade and tea, both of 
which were made of distilled water. She did not suffer 
an hour's inconvenience during the whole time, the 
birth was easy and the child though very soft at first 
grew rapidly and became large and strong. 

Numerous others have tried it that we know of and 
have been reported by others, and not a few have come 
under our own observation, in all of which the results 
are mainly the same. Several have tried the plan at 
my suggestion and the results have in every instance 
been highly satisfactory. 

Those nations among which childbirth is compara- 
tively easy, subsist mainly on a diet in which bony 
materials are very limited. Females of tropical 



90 PAINLESS CHILDBIRTH 

climates where the diet is very largely fruit suffer very 
little at childbirth. The American Indians eat very 
little wheat and the same is true of the colored slaves 
of the South. 

It is a very popular but erroneous idea that the mother 
must gorge herself throughout pregnancy in order to 
support and nourish the unborn — that she must "eat 
for two." This is a very great mistake. On the con- 
trary, instead of eating more than she wants she 
should be governed by the dictates of hunger and never 
eat an extra mouthful. The amount of nourishment 
the foetus requires day by day is very trifling indeed. 
As a result of such a mistaken notion she disorders 
the stomach, becomes heated and feverish, is troubled 
with headache and dizziness and lays herself liable to 
numerous intestinal disorders; and if assimilation is 
active in proportion to the increased amount eaten 
she becomes extremely fleshy and uncomfortable and 
will be liable to much annoyance from swelling, cramp- 
ing or numbness of the extremities. 

Figure the matter out for yourselves: The average 
duration of pregnancy is two hundred and eighty days; 
the average weight of the child and placenta {after- 
birth) does not exceed ten pounds and generally not 
over eight; then ten pounds give one hundred and 
sixty ounces, or but little more than half an ounce a 
day is required. 

Admitted that during the first four months the 
amount required will be much less than in the last 
four, as we more nearly approach delivery the greater 
will the amount required become; nevertheless, the 
average remains the same. Laying the question of 
average aside there is no use of the mother commencing 



DIETETIC MEASURES 91 

to lay in a surplus for at least the first six months, 
though during the last three the amount of nourish- 
ment might be slightly increased. She should also bear 
in mind that if by excessive eating she increases the 
nutrition of her child she increases its growth, and for 
every ounce she increases its development beyond a 
given point she unwisely diminishes the ease of delivery. 
Numerous authorities might be cited on the subject, 
but we do not regard them necessary; the proposition 
is too easy of comprehension to require argument and 
unless morbid conditions supervene to require a modifi- 
cation of the amount eaten for therapeutic purposes 
the dictates of hunger will be by far the best guide how 
much will be best, always bearing in mind, let modera- 
tion in all things prevail. 



CHAPTER IX 



REMEDIAL TREATMENT 

Although the measures already advised are of the 
utmost importance and will certainly exert a powerful 
influence over the ease and safety of delivery, the 
mother's recovery and the future welfare of the child, 
there remains to be considered other agencies in the 
efficacy of which we have almost unlimited confidence — 
agencies which exercise a positive curative influence 
over those abnormal conditions that so frequently 
attend or co-exist with pregnancy and which so often 
complicate and increase its difficulties. 

These agencies — therapeutic in character — may be 
employed in conjunction with the hygienic and diet- 
etic measures already detailed, and will act in perfect 
harmony with them and mutually increase the value 
of each other. 

We have seen the dietetic and hygienic measures 
employed alone with the most decided benefit; and 
have in other cases tried the therapeutic treatment 
we are about to advise — when the other could not be 
made available — with the effect of rendering the labor 
short, easy and safe, as well as controlling any un- 
pleasant symptoms that presented during the progress 
of the pregnancy. 



REMEDIAL TREATMENT 93 

All women are not affected in the same manner — 
all constitutions are not alike — and we will often ob- 
serve pathological conditions occurring during preg- 
nancy which had their origin long before the concep- 
tion took place; or pathological conditions may be 
developed during gestation. There may be abnormal 
conditions which do not depend for their present exist- 
ence nor are in way connected with pregnancy, yet, if 
allowed to proceed will seriously militate against a 
short, easy or safe delivery. Again, these morbid condi- 
tions may have an intimate connection with the gesta- 
tory or pregnant state. The present and future welfare 
of both mother and child necessarily depends greatly 
upon our ability to control or remove these conditions. 

At the risk of seeming inconsistent or of appearing 
to lack confidence in what I have already written and 
advised in the preceding chapters I shall consider those 
remedial agents which have in my hands and in the 
hands of my professional acquaintances accomplished 
so much for the relief of suffering women. 

There is a tradition that the Indian women of this 
country for two or three months prior to delivery resort 
to drinking an infusion of a plant known as squaw vine 
or partridge berry in order to render their delivery easy 
and safe. Whether this tradition has any foundation 
in fact or not, I do not know, nor does it seem that I 
need care, so long as the tradition has developed a 
knowledge of a remedy of the greatest possible conse- 
quence to the parturient female. Whether the squaws 
drink it or not, there is nothing more certain to my mind 
than that it does possess the truly wonderful and benefi- 
cent properties ascribed to it. 



94 PAINLESS CHILDBIRTH 

In the American Dispensatory, by Dr. John King, 
we find the following reference to it: 

It is said that the squaws drink a decoction of the plant for 
several weeks previous to their confinement for the purpose of 
rendering parturition safe and easy. ******** 
Partridge berry is parturient, diuretic and astringent, used in 
dropsy, suppression of urine and diarrhoea. It seems to have a 
special affinity for the uterus and is highly beneficial in all 
uterine diseases. It appears to exert a powerful tonic and alter- 
ative influence on the uterus. Dose of the strong decoction, 
from two to four fluid ounces two or three times a day. The 
berries are a popular remedy for diarrhoea and dysuria. It is 
highly recommended as a remedy for sore nipples, used as fol- 
lows : Take two ounces of the herb, fresh, if possible, and make 
a strong decoction with a pint of water; then strain and add as 
much good cream as there is liquid of the decoction; boil the 
whole to the consistency of a soft salve and, when cool, anoint 
the nipples with it every time the child is removed from the 
breast. 

Hale, in his New Remedies, says: 

I would recommend it for false pains, uterine irritability, 
scanty and delaying menses, dysuria and scanty urine with profuse 
sediment. 

In procuring this remedy it is best to obtain it by 
its botanical name, Mitchella Repens, as there are 
several plants known in different parts of the country 
by the name of squaw vine, squaw berry, squaw mint, 
partridge berry and other similar names which would 
have a tendency to confuse anyone not familiar with 
botany, and it is necessary to get the right plant. 

An infusion is always the best form for administra- 
tion and will be found most efficacious, for I must 
confess, though I have tried several specimens of fluid 
extracts, they have failed to afford the satisfaction I 
have derived from the infusion of the recently gathered 
plant. It is advisable not to rely on the plant that has 



REMEDIAL TREATMENT 95 

been gathered more than a year, as it is apt to lose its 
strength and become inert if kept longer. 

The action of this remedy either alone or in combi- 
nation is to act gently upon the kidneys and urinary 
organs, relieving irritability and moderately increasing 
the flow of urine. It cleanses the blood, soothes any 
nervous excitement that may exist, removes pain and 
soreness and effectually overcomes any morbid inflam- 
matory conditions of the female reproductive organs, 
strengthens the uterus and establishes such a healthy 
condition as results in an easy and safe delivery. 

When the lower extremities are swollen as is often 
the case after the pregnancy is well advanced, owing 
to an obstruction of the circulation, I have seen this 
remedy produce the most decided and speedy relief. 
I have given it in the treatment of various uterine 
disorders with the most satisfactory results, but the 
consideration of those complaints having been made 
in this edition the subject of a separate chapter, further 
allusion to such use of it at this time is unnecessary. 

There is another plant that possesses a similar and 
deserved reputation, and I have frequently combined 
them with the happiest results. I allude to blue cohosh, 
the botanical name of which is Caupolhyllum Thalic- 
troides, also known as squaw root, of which Dr. Hale 
in his recent popular work on New Remedies says: 

The aborigines and early settlers claimed for it the power of 
preventing tedious and painful labors. This testimony has been 
substantiated by many prominent and trustworthy physicians of 
the eclectic school as well as of the homoepathic. A few of 
our school have denied it such power, but the weight of evidence 
is against them. Dr. A. E. Small is sure from the observations 
of many years that it actually prevents the usual sufferings 
which many women undergo. He also testifies to the singular 



96 PAINLESS CHILDBIRTH 

fact that many women who have taken it for such purposes have 
overrun their time to the extent in some cases of ten cr twelve 
days. The cases referred to, however, all had very easy labors 
and a good recovery. 

My experience has been so uniform and conclusive on this 
point that I do not hesitate to assert that it prevents not only a 
too painful labor, but it prevents those premature labors which 
are so common among the weakly women of this age. 

I have repeatedly used a combination of the two 
with the most satisfactory results. I obtained the 
fresh materials and administered them in the form of 
a sweetened infusion, sometimes adding other agents 
that seemed specially demanded. In very many in- 
stances have I made use of these remedies in cases 
which had hitherto undergone the most terrible suffer- 
ings at parturition, with the effect of enabling the 
mother to have a very speedy delivery, almost abso- 
lutely free from pain. In those females who had taken 
it there was very little of the inconvenience usually 
experienced in the latter months of gestation; the 
mothers made a wonderfully speedy recovery and in 
some instances were entirely relieved of uterine dis- 
orders to which they had for several years previously 
been subject. 

While practicing medicine in the central part of the 
State of New York so favorable were the results attained 
by using the foregoing remedies in the form of sweet- 
ened infusions which I then prepared, the remedy ac- 
quired such a reputation that very many parturient 
women procured it that they might go through child- 
birth without pain; and though it was taken in hun- 
dreds of cases where I could not attend the confinement 
I have never known of a single instance of failure; 
but, on the contrary, received many testimonials of 



REMEDIAL TREATMENT 97 

its efficacy and thanks for the benefits derived from it. 
There are many women who will remember taking 
what I then termed the "mother's cordial," the com- 
position of which I did not reveal to them, but which 
consisted mainly of an infusion of the squaw vine and 
blue cohosh preserved with sufficient sugar and alcohol 
to render it palatable and secure its preservation while 
being used. 

In using an infusion of these plants an ounce of 
the squaw vine and half an ounce of blue cohosh should 
be steeped in a pint of water and the whole taken in 
the course of three or four days. When one is used 
alone a greater quantity should be employed than when 
both are used together. 

A very convenient and agreeable combination may 
be made thus : 

Squaw Vine, J^ pound 

Blue Cohosh, J£ pound 

Bruise them thoroughly and add one gallon of water and let 
them stand over night. Then heat them nearly to the boiling 
point and gradually reduce the quantity of liquid (occasionally 
letting it come to a boil) to one half, strain and press out all the 
liquid, which should measure three pints, add 1 pound of loaf 
sugar and dissolve; then add spirits to make the whole meas- 
ure two quarts. The dose should be a tablespoonful three to 
five times a day. The spirits are only added to preserve the 
preparation and need not be added when the infusion is made 
in small quantities to be used before it would sour. In cold 
weather a less quantity of spirits will suffice. Whisky, gin or 
alcohol may be used. 

There is still another plant that is indigenous to 
this country which enjoys a growing reputation, not only 
for the relief of those morbid conditions that render ges- 
tation and delivery painful and tedious, but as a remedy 



98 PAINLESS CHILDBIRTH 

to expedite delivery. I refer to the black cohosh or Cimi- 
cifuga Racemosa also known as macrotys. Given in 
small doses for two or three weeks there can be little 
doubt that it has the power of rendering the labor 
very short and easy. 

Dr. Scudder of Cincinnati, editor of the Eclectic 
Medical Journal, speaks positively on the subject as 
follows : 

Pregnancy is a physiological condition and there should be 
little or no pain, ache or unpleasantness associated with it. If 
there is it should be looked after at once and removed. These 
unpleasantnesses can and should be relieved for the comfort of 
the mother and more especially because this will probably ren- 
der the labor easier and the getting up better. Let me again 
call attention to macrotys as partus preparatory though doubtless 
most of our readers have tested it. If there are pains and aches 
in the region of the uterus, tenderness on pressure or soreness 
at any part of the uterine globe; if the movements of the child 
are painful or there is pain in the pelvic articulations or, finally, 
if during the last month there are false pains, macrotys is likely 
to be a remedy. I have used it time and again in these cases with 
relief and in others during the last six or eight weeks of gesta- 
tion simply to facilitate and make the labor easier, and I am 
satisfied with good results. 

In Hale's New Remedies the author makes the fol- 
lowing allusion to it: 

Dystocia (difficult labor) is one of those abnormal conditions 
which come under the domain of homeopathic medication. It 
is useless to cling to the antiquated superstition that a woman 
must suffer the " pangs of childbirth." Dystocia is always the 
result of an abnormal condition of the tissues concerned in the 
functions of childbearing. *********** 
I have attended many women whose previous labors had been 
exceedingly painful — almost unendurable without ether — but, 
owing to the administration of cimicifuga during the last weeks 
of pregnancy they suffered very little. So many of these cases 
have occurred in my practice and in that of my colleagues that 



REMEDIAL TREATMENT 99 

it is not proper to affect skepticism or unbelief. As a rule, first 
labors are painful and protracted, while subsequent ones are less 
so; but if five or six are very painful and each one seems to be 
more painful than the last we cannot expect the seventh to be 
painless except from some remedial interference. Now, if in 
such cases cimicifuga, caulophyllum or viburnum is given and the 
woman's next labor is easy, what are we to think? Evidently, 
that the medicine effected a change of condition from abnormal 
to normal. 

In such cases give the cimicifuga at least two weeks previous 
to the expected date of labor, in doses of one to ten drops two 
or three times a day, the doses repeated oftener as the date ap- 
proaches. 

The preparation alluded to by Prof. Hale is the 
homeopathic mother tincture and when it can be ob- 
tained will represent very certainly the virtues of the 
drug. An infusion of the root, one half ounce in a pint 
of boiling water of which the dose may vary from a 
teaspoonful to a tablespoonful repeated three or four 
times a day, will also answer. The fluid extract, when 
reliable, in doses of from three to eight drops may be 
used. When the homeopathic tincture cannot be readily 
obtained the following procedure will answer: 

Black Cohosh Root, 34 pound 

Alcohol, . . . . . }/2 pint 

Bruise the cohosh as fine as possible and put it in the alcohol, 
cork and let it stand a week or two, occasionally shaking the 
same. At the end of this time it may be strained and used in 
doses as advised for homeopathic tincture. 

Dr. J. H. Dye's Mitchella Compound contains both 
cohosh and squaw vine as well as other ingredients. 
It should be taken daily for as many months of preg- 
nancy as possible. Thousands of testimonials bear wit- 
ness to the wonderful healing and pain-relieving powers 
of Mitchella Compound. 



100 PAINLESS CHILDBIRTH 

CONSTIPATION 

Every effort should be made to keep the bowels 
open and regular. A daily evacuation of the bowels is 
essential to health, and to neglect for several days 
together the performance of so important a function 
is highly prejudicial, for if long continued it sooner 
or later develops a variety of ailments often of a serious 
character, among which we may notice feverishness, 
loss of appetite, indigestion, wakefulness, headache, 
horrible dreams, sickness of the stomach, bearing down 
pains, piles, etc. 

This troublesome complaint is more easily prevented 
than cured, though a cure can almost always be effected. 
Habit has very much to do with its development and 
cure. The habit of evacuation should be encouraged 
daily, and the best time is in the morning, soon after 
breakfast; the bowels having then been quiet during 
the night are stimulated to activity by partaking of 
food and consequently have a natural tendency to act 
at this time, and whether the desire is felt or not the 
attempt should be made, which may be aided by an 
injection of tepid water. The influence of the diet and 
exercise which have already been recommended is 
exceedingly beneficial in preventing and curing cos- 
tiveness. A glass of water drank at night and another 
the first thing on rising, and an orange eaten before 
breakfast will work wonders. If the woman is of full 
habit and costive I would' advise a small quantity of 
Epsom salts daily, just enough at a dose to produce a 
free, natural evacuation. They cool the system, re- 
lieve determination of blood to the head, with dizziness, 
swelling of the feet, etc., prevent nausea and a host 
of the disorders that attend constipation. We are 



REMEDIAL TREATMENT 101 

well aware the taste of salts renders them objectionable 
to very many. When such is the case they may be dis- 
guised and their value enhanced by dissolving them 
in hard cider in the proportion of half a pound of the 
salts to a gallon of old cider of which the dose will be 
two to four ounces once or twice a day. The object 
being to maintain a natural condition, the dose must 
necessarily be varied accordingly. 

Other saline laxatives may be used in their stead, 
such as Rochelle salts, seidlitz powders, citrate of 
magnesia, Carlsbad salts, sodium phosphate or mineral 
water, etc., in quantities sufficient to regulate the 
bow T els. 

It so happens that women w r ho are not plethoric are 
often troubled with constipation; indeed, constipa- 
tion in them is a very common condition and is often 
a source of very great trouble. Such women should 
eat abundance of cereals, fruits and vegetables — oranges, 
apples, prunes, figs, tomatoes, spinach, beans, peas, etc. 
A soap and water enema, a glycerine suppository or the 
injection into the bowel of four to six ounces of olive 
oil may be used occasionally for temporary relief, but 
strong, violent purgatives should be scrupulously 
avoided. Mild tonic laxatives, however, maybe needed, 
and of these the best are Cascara Sagrada, Phenoph- 
thalein and Compound Licorice Powder. From five 
to thirty drops of the fluid extract of Cascara Sagrada 
or one or two teaspoonfuls of the cordial taken in a 
little water morning and night will usually be followed 
by happy results. If preferred a two or three-grain 
Cascara tablet may be taken at bedtime. 

Phenophthalein is best taken in the form of a one- 
grain tablet two or three times a day after meals. Many 



102 



PAINLESS CHILDBIRTH 




Figure 10 
women find a teaspoonful of Compound Licorice Pow- 
der in half a glass of milk at bedtime a very mild and 
satisfactory laxative. 

THE KIDNEYS 

The condition of the kidneys must always be remem- 
bered and any irregularity corrected. When the 



REMEDIAL TREATMENT 103 

kidneys are not kept sufficiently active the general 
health suffers, and if this condition occurs about the time 
of delivery it renders convulsions liable. Inactivity of 
the kidneys is sometimes the cause of the swelling and 
dropsical condition of the lower extremities, though 
such a condition is usually due to pressure of the en- 
larged uterus upon the returning current of blood 
through the veins into general circulation. 

The total amount of urine passed in twenty-four 
hours should be estimated from time to time, and a 
sample sent to the physician tor examination. This is 
particularly advisable when such symptoms as puffi- 
ness of the eyes or swelling of the hands, feet or ankles 
appear. Convulsions at the time of confinement are 
very often the result of kidney disease. The diet we 
have recommended will usually keep both bowels 
and kidneys in a normal condition and Dr. Dye's 
Mitchella Compound being diuretic is generally all 
that will be needed; but, should the urine become 
scanty, the following may be relied upon and will 
restore the kidneys to a healthy condition: 

Acetate of Potash, ... 1 dram 

Sweet Spirits of Nitre, . . 3 drams 

Simple syrup to make, . . 2 ounces 

Dose — one teaspoonful in water three to six times a day. 

MORNING SICKNESS 

Much good may be anticipated from the dietetic 
and hygienic advice already given, for among those 
who have tried it the absence of this annoyance was 
particularly noted. I am led to believe that the sick- 
ness and vomiting of pregnancy depend more upon 
those unnatural conditions developed by the imposi- 
tions of modern social customs than upon any natural 
relation to reproduction. 



104 PAINLESS CHILDBIRTH 

The power of Dr. Dye's Mitchella Compound to 
control irritable conditions of the uterus renders it a 
very effectual remedy in the nausea and vomiting of 
pregnane}', though its action on the stomach directly 
is of no consequence. When the sickness and vomiting 
occur immediately on getting up they may be prevented 
by taking the breakfast while lying quietly in bed. 
Small pieces of ice slowly dissolved in the mouth and 
swallowed, often have an excellent effect, and so do cold 
compresses applied over the stomach or back of the 
neck. 

Innumerable remedies have been recommended for 
the relief of morning sickness, but there is no known 
specific and it is often necessary to try one remedy 
after another, because that which will relieve or cure 
one may utterly fail in another. 

The bowels should be kept open and if solid food 
seems to increase the nausea or vomiting, liquid foods 
such as milk, plain or mixed with soda water or lime 
water, or well strained broths should be given in small 
quantities at frequent intervals. 

Relief sometimes comes from abstaining from all 
kinds of food for several hours or even for a whole day. 

A cracker eaten dry before the head is raised from 
the pillow is a simple remedy well worth a trial. So 
are pop corn, ice cream, scraped beef, junket, spruce 
chewing gum and iced champagne. 

A sour stomach and heartburn are often helped by 
equal parts of milk and lime water in tablespoonful 
doses every hour, Vichy water or bicarbonate of soda. 

The mustard or capsicum plaster is worthy of a 
trial, as is also a plaster composed of various spices 
applied over the pit of the stomach. 



REMEDIAL TREATMENT 105 

The acid fruit diet generally controls the sickness 
and arrests or prevents the vomiting, and for this 
purpose lemon juice is often valuable. It may be taken 
in doses of a tablespoonful mixed with an equal part 
of water. 

The effervescing solution of citrate of potassa or 
magnesia is sometimes very efficacious and acts as a 
laxative at the same time; and being an agreeable 
drink will often be tried before other means are resorted 
to. It will be in harmony with the principles of the 
fruit diet. 

When headache and nervousness are prominent symp- 
toms, bromide of potassium is an efficient remedy and 
may be given as follows: 

Bromide of Potassium, . . 2 drams 

Cinnamon Water, ... 3 ounces 

Dose — two teaspoonfuls in a wineglassful of water two or three 
times a day. 

If previous instructions are obeyed, this prescription will 
very rarely be needed. 

Should the stomach reject this it can be given as a 
rectal injection. Thirty to sixty grains dissolved in 
three ounces of liquid starch injected and retained in 
the bowel is the proper amount. 

Many cases are relieved by taking 10 to 15 grains 
of subnitrate of bismuth three times a day or 5 grains 
of the oxalate of cerium before each meal, or one drop 
of the wine of ipecac in one half teaspoonful of water 
every hour, or 5 to 10 drops of the tincture of nux 
vomica in water three times a day. 

When the stomach becomes so irritable that all 
kinds of food and medicine no matter how given are 
rejected, the general nutrition fails and weakness or 



106 PAINLESS CHILDBIRTH 

exhaustion supervenes. In such cases it is necessary 
to feed by the bowel — rectal feeding. This is done as 
follows: Wash out the rectum by irrigating it with 
plain warm water from a fountain syringe. Then intro- 
duce high up in the bowel through a rubber tube or 
catheter from 4 to 6 ounces of peptonized milk or broth 
or the whites of two or three eggs in water. To pre- 
vent its ejection the woman should remain quiet and a 
slight pressure made against the anus for a few minutes. 

LONGINGS— CRAVINGS— DEPRAVED APPETITE 

Depraved appetite is regarded by many as a signifi- 
cant sign of pregnancy. The woman may be seized 
with a desire for some unnatural substance, and will 
often eat chalk, magnesia, charcoal, slate-pencil, etc. 
She often wants some article of food which she may 
have previously disliked, and often such articles will be 
found acceptable. When it can be done without too 
great an inconvenience this morbid appetite or longing 
may be gratified, but when it cannot, the woman should 
dismiss it from her mind. We do not place as much 
stress upon the gratification of these unnatural appe- 
tites and desires as many, yet, as they afford a comfort 
to the mother we suggest that when reasonable and 
practicable they may be indulged. A healthy condi- 
tion of every function will soon do away with them, 
and to this end we should seek to improve the woman's 
condition by every possible means, rather than attempt 
to relieve such desires by special means alone. The 
course already prescribed will generally soon overcome 
longings, and to give her some unexpected article of 
diet will often break the " longings." If a morbid 
condition exists in the stomach let it be met with 



REMEDIAL TREATMENT 107 

appropriate remedies. Diseases of the stomach not be- 
longing to this treatise must be omitted. 

LOSS OF APPETITE 

If the appetite fails, let the woman abstain from 
eating for a meal or so; or if her strength fail on ac- 
count of it let the appetite be " coaxed" by some 
unexpected delicacy, and small quantities of highly 
nutritious food be tried. Those who try our hygienic, 
dietetic and remedial plan will seldom be annoyed by 
loss of appetite or such morbid conditions; but should 
they fail, change of climate, scenery or surroundings 
will often work winders when combined with the treat- 
ment recommended for morning sickness. Should they 
fail, it will be advisable to consult a physician. 

FLATULENCY— GAS IN STOMACH AND BOWELS 

Flatulence generally comes from a bad state of the 
digestion and is often associated with colic. In such 
cases it will be found better to eat a little and often 
than to eat at long intervals and much at a time. 
Certain articles of diet will induce an attack and when 
they are known should be avoided. Allowing a weak 
or irritable stomach to go long empty and then filling 
it to repletion will generally provoke an attack of colic 
if anything will. 

Avoid indigestible articles of diet, chew the food 
thoroughly, and if remedies are needed a grain or two 
of cayenne pepper will often relieve, or ten to fifteen 
drops of tincture of capsicum and myrrh (No. 6) in 
sweetened water. They act by increasing the power 
of natural digestion. A little peppermint or camphor 
water or a soda mint tablet will generally expel the 
wind and give relief. An injection to move the bowels 
will succeed. Some of these plans are generally 



108 PAINLESS CHILDBIRTH 

available and can be had on short notice, but as a 
remedy nothing can excel the following: 

Tincture of Colocynth, . . 15 drops 

Water, ..... 4 ounces 

Dose — A teaspoonful repeated every fifteen to twenty min- 
utes during the attack and, afterwards, to break up the tendency 
of the trouble to return, a teaspoonful three or four times a day 
for several days. 

VARICOSE VEINS 

The veins of the lower extremities frequently be- 
come distended, knotted and painful. They do not 
often show themselves in the first pregnancy, but are 
apt to appear later in life and become worse with each 
successive pregnancy. They are very much aggravated 
by tight garters and corsets, neither of which should 
be worn during this condition. They are caused and 
aggravated by any circumstance that is capable of 
impeding the return of venous blood from the extremi- 
ties. 

A free action of the kidneys, skin and bowels has 
a tendency to relieve them and I have seen them greatly 
benefited by Dr. Dye's Mitchella Compound. Rubbing 
the extremities towards the body aids in emptying 
them and is beneficial. A well-adjusted laced or elastic 
stocking is one of the best remedies and can be obtained 
from a druggist or surgical-instrument maker. A roller 
bandage applied from the toes to the body answers the 
same purpose, but is difficult to apply so as to make 
an even pressure and admit of freedom of locomotion. 
An elastic perforated bandage is easily applied and 
retained in place. When neither of these means is 
available, and the veins are troublesome, the woman 
should remain in the recumbent position as much as 
possible or sit with the feet well elevated. An 



REMEDIAL TREATMENT , 109 

abdominal bandage so adjusted as to raise the uterus 
and its contents upward and thus remove the pressure 
from the large veins as they pass upward through the 
pelvis will also be effectual. 

HEARTBURN 

Pregnant women are frequently troubled a good 
deal by the distressing symptom called heartburn, for 
which it is customary to resort to alkalies. They merely 
neutralize the acid that is in the stomach, but do not 
arrest the causes to which it is due. The use of alkalies 
interferes with the principle of fruit diet and should 
be avoided if possible. Heartburn is generally due to 
an impairment of digestion and in too many cases to 
over-eating — the food fermenting instead of digesting. 

The proper treatment is to avoid it by abstemious liv- 
ing but, if it occurs, try fasting — or skip a meal occa- 
sionally. I have found those remedies that aid digestion 
to be the most valuable in relieving it. Five to ten 
grains of pepsL. just before or after a meal w T ill often 
succeed. Charcoal will be found available in many 
cases and is less objectionable than alkalies. Five 
grains of sub-nitrate of bismuth repeated three to six 
times a day is an effectual remedy. I have often found 
acids among the best remedies. The following is usually 
a successful prescription: 

Dilute Nitro-Muriatic Acid, . 3^ ounce 
Water, ..... 4 ounces 

Dose — A teaspoonful in a wineglassful of water after eating. 

It may be greatly aided by diminishing the quan- 
tity eaten and also by avoiding saccharine and starchy 
food. 

PILES 

This distressing complaint is one of the frequent 



110 PAINLESS CHILDBIRTH 

annoyances of gestation and may be caused by pro- 
longed constipation or anything that obstructs the 
hemorrhoidal veins. Those women of a full habit are 
especially liable to them. Ordinarily, the pile tumors 
are small and are of little consequence beyond the 
annoyance they occasion; but when they are large, 
painful and become inflamed they require the services 
of a physician, for while an operation for their radical 
cure is seldom justifiable during pregnancy every effort 
to obtain relief is a duty. In treatment the first point 
to be looked after is to secure and maintain a moderate- 
ly open condition of the bowels. This may be secured 
by the fruit diet, exercise, bathing and injections. 
Senna tea is a favorite laxative in this condition. 
Avoid straining at stool. A piece of absorbent cotton 
saturated with witch hazel and inserted just inside 
the anus after stool is a simple remedy worth trying. 
Wash the parts thoroughly in cool water and apply 
the following ointment : 

Gall Ointment, .... 1 ounce 
Stramonium Ointment, . . 1 ounce 

Directions — Apply locally morning and night, at the same 
time inserting a little of the ointment just inside the bowel. 

When very painful, relief is sometimes obtained by 
elevating the foot of the bed a few inches and apply- 
ing hot fomentations to the affected region. A physician 
may be needed to open the pile and turn out the small 
blood clot. The abdominal bandage should be worn. 
Piles often disappear entirely after confinement. 

DIARRHOEA 

Looseness of the bowels often occurs as a sequel of 
constipation or in alternation with it. Some women 
are troubled with it more or less the entire term, while 



REMEDIAL TREATMENT 111 

others are afflicted with frequent attacks sometimes 
coming on without any assignable cause. When it 
occurs as a sequel of the constipation it is generally 
of a watery character secreted by the lining membrane 
of the bowels as an effort of nature to discharge the 
retained waste matter. When not severe it is salutary 
and relieves headache, heartburn, nausea, etc., and 
usually regulates itself when the offending materials 
are discharged. When, however, it is severe or pro- 
longed it should receive proper attention, for then it 
weakens and predisposes to piles and abortion. 

Ordinarily, very little medicine need be given, for 
rest in the recumbent position and a strict diet will be 
sufficient. 

Should the diarrhoea continue give a dose of castor 
oil and after it has operated use the following: 

Tincture of Catechu, 6 drams 

Laudanum, .... 40 drops 

Chalk Mixture to make . 4 ounces 

Dose for an adult — One tablespoonful three times a day. 

The following mixture will be found equal to almost 
any case, having been repeatedly tested by myself 
and others, and is appropriate to a great variety of cases * 

Chloroform, .... 2 drams 

Tincture Opium, ... 1 dram 

Tincture Camphor, ... 2 drams 

Tincture Rhubarb to make . 2 ounces 

Dose — one half to one teaspoonful, repeated according to the 
severity of the attack from one to four hours, until relieved. It 
may be preceded or followed by a mild dose of castor oil, with 
advantage. 

HEADACHE AND NEURALGIA 

A very large proportion of pregnant women are 
troubled with headache and neuralgic pains in the face, 



112 PAINLESS CHILDBIRTH 

breast or side of the chest. The causes are numerous. 
The influence of pregnancy upon the nervous system 
contributes to the production of headache by inducing 
determination of blood, constipation, indigestion and 
is liable to aggravate neuralgic, rheumatic and consti- 
tutional headache. We can usually do more to cure 
headache by attention to diet, exercise and overcoming 
the causes that occasion it than by any special remedies 
addressed to the head. If it persists after the appre- 
ciable causes are removed it will be best to consult a 
physician. Those who carry out the advice already 
given in this and the two preceding chapters will not 
be troubled much with these aches and pains. Bromide 
of potash and ammonia in solution, as recommended for 
convulsions, in teaspoonful doses every three or four 
hours will be apt to relieve these headaches. 

For the neuralgic pains in the chest, face or breast 
use mustard plasters, hot fomentations, hot water 
bag, hot salt bag or a liniment containing camphor 
and chloroform. Painful spots may be painted with 
iodine. 

COUGH 

A troublesome cough sometimes occurs, but unless 
it becomes so severe as to prevent sleep or endanger 
miscarriage by the violent concussion of the abdomen 
it produces it seldom requires attention. A teaspoonful 
of paregoric occasionally repeated will usually afford 
relief, but as I do not desire to use opiates when they 
can be avoided, before resorting to the use of paregoric 
I would try a teaspoonful of either of the following: 

Tincture Colinsonia, ... 1 dram 
Water, ...... 4 ounces 

Mix. 



REMEDIAL TREATMENT 113 



Tincture Drosera, ... 2 drams 
Water, ..... 4 ounces 



Or 

Mix. 
Or 

Tincture Red Clover, . . 1 dram 

Water, ..... 4 ounces 
Mix. 

Or, an infusion of red clover may be drank in small quantities. 

This does not apply to diseases of the lungs, as con- 
sumption or bronchitis. Such diseases need experienced 
professional advice. 

PRURITUS, OR ITCHING 

Some women will be troubled with intolerable 
pruritus, or itching, of the genitals and adjacent parts. 
While it is occasionally met among women not pregnant 
it is more often an accompaniment of gestation. It 
frequently occasions the most exquisitely excruciating 
agony. The desire to rub or scratch the parts may be 
almost irresistible even during sleep, and the skin may 
become excoriated and sore. The itching may be purely 
nervous in origin, but may also result from irritating 
and acrid vaginal discharges and from such diseases 
as diabetes, jaundice or Brights disease. Absolute 
cleanliness — the frequent use of water — is one of the 
first requisites of relief, and to this end we can heartily 
endorse Dr. Shew's advice in regard to the use of the 
sitz bath. Maintain the most perfect cleanliness of 
the vagina and those structures that can be in any way 
influenced by its secretions. The sitz bath may be used 
as often as the itching returns — several times a day. 
After the bath a lotion of borax in water may be ap- 
plied, say one ounce of borax to a pint, or two teaspoon- 
fuls of aromatic spirits of ammonia in a glass of water, 



114 PAINLESS CHILDBIRTH 

or sulphite of soda, one ounce to the pint, applied freely. 
These lotions may he applied successively until relief 
is obtained. 

The following lotion used after bathing the parts 
will often succeed when others fail. 

Borax, . . . . 2 drams 

Oil of Peppermint, . . .6 drops 

Hot Water, .... 1 pint 

Directions — Use locally as a lotion. 

Nervous women suffering from local pruritus should 
take asafoetida or valerian pills, but when the trouble 
is caused by constitutional diseases she should place 
herself in the care of her family physician for proper 
treatment. 

Occasionally there is an itching of the whole body 
without any rash or eruption on the skin. Relief can 
often be obtained by a prolonged soda or alkaline bath 
followed by a smearing of the skin with plain or car- 
bolized vaseline. 

FAINTING 

It may occur at any period of gestation, especially 
when tight lacing is indulged in or the woman has to 
remain long in heated rooms or bad air. It is especially 
liable to occur at " quickening. " It is to be treated 
the same as when it occurs at other times. Lay the 
patient in an easy position, the head low, and loosen 
the clothing; allow the cool air to blow in the face; 
sprinkle a little water in the face or have her inhale 
the fumes of ammonia or "hartshorn" as it is more 
commonly called. Camphor may be rubbed upon the 
face and neck. Avoid excitement or alarm. She should 
remain in a recumbent position until entirely recovered. 



REMEDIAL TREATMENT 115 

In the interval between the attacks a 3-grain pill 
of asafoetida after meals should be given to nervous, 
hysterical women in whom fainting spells are most 
likely to occur. 

PALPITATION 

This is a frequent annoyance and is most liable to 
occur in nervous women and those who pay too little 
attention to the rules we have already prescribed. 
In the early months it is generally sympathetic, but 
later on is usually caused by the enlarged womb inter- 
fering with and embarrassing the action of the heart. 

Pale, nervous women suffering from palpitation need 
fresh air, easily-digested food and a good iron tonic. 
Asafoetida sometimes does good and a belladonna 
plaster applied over the heart often gives relief. The 
bowels should be regular. Palpitation often disappears 
at the time of lightening — about two weeks before 
confinement. 

MOTH OR LIVER SPOTS 

^Yhen these spots occur on the face they are very an- 
noying to some. The general supposition is that they 
cannot be removed. Painting them once or twice with 
the compound tincture of iodine (Lugol's solution) will 
usually remove them. Those who would object to 
the color of the iodine while it remains may try the 
colorless tincture of iodine. Apply thoroughly. 

A good lotion is: 

Corrosive Sublimate, ... 1 grain 

Tincture of Benzoin, . 3^2 dram 

Almond Emulsion, ... 1 ounce 

Directions — Apply to discolored spots night and morning. 

Warning — Corrosive Sublimate is very poisonous, and care 
should be taken that none of the lotion gets into the eyes. 



116 PAINLESS CHILDBIRTH 

Many cases have been cured with the following 
ointment : 

Ammoniated Mercury, . . 1 scruple • 
Subnitrate of Bismuth, . . 1 dram 
Vaseline, ..... 1 ounce 
Directions — Apply to spots night and morning. 
TOOTHACHE 

The frequent occurrence of toothache in pregnancy 
explains the origin of the old proverb "For every child 
a tooth." 

Warm applications and other home remedies should 
be used until a dentist can be consulted. In the average 
case there is no good reason why a tooth should not 
be treated or extracted or a cavity filled during preg- 
nancy just as at other times. But long, tedious opera- 
tions on the teeth, such as crown and bridge work, 
should be postponed until after confinement. 

IRRITABILITY OF THE BLADDER 

Many women suffer during the entire term of preg- 
nancy from an almost constant desire to empty the 
bladder, compelling them to urinate every few minutes, 
passing a few drops at a time with pain and burning. 

In the early months it may be due to mechanical 
irritation from pressure of a displaced uterus against 
the neck of the bladder, and later on from pressure 
upon the body of this organ. In numerous other 
instances, however, it cannot be attributed to any 
such mechanical cause, but is due to some abnormal 
condition of the bladder itself. Usually, the urine is 
not increased in quantity, but rather diminished and 
often scalding. 

The measures already advised in the chapter on 
hygiene and diet will usually prevent this trouble, 
or the employment of Dr. Dye's Mitchella Compound 



REMEDIAL TREATMENT 117 

will overcome it, but occasionally a case may resist 
these means. I would then advise: 

Fluid Extract Gelseminum, . 15 drops 

Fluid Extract Populus, . . 1 dram 

Water, ..... 2 ounces 

A teaspoonful every two or three hours till relieved, to be 
renewed if the trouble occurs again. 

I have also found the homeopathic remedies, can- 
tharis or apis, to relieve this condition. I have employed 
them by putting five drops of the mother tincture in 
half a glass of cold water and giving a teaspoonful 
every hour until relieved. As soon as relieved stop 
taking them. A tea made of couch grass, slippery elm 
or flaxseed drank freely is a very efficient remedy for 
this complaint. Five drops of the tincture of nux 
vomica in a little water three times a day for a week 
or two is a useful remedy. If the bladder be inflamed 
a five-grain tablet of urotropin should be taken three 
times a day and a physician consulted as to the advisa- 
bility of washing out the bladder. 

NERVOUSNESS 

Those who are subject to nervousness know what 
it is without any special description. The nervous 
system is impaired, irritable, and though there may 
not be any pain the sensation is even worse; no posi- 
tion seems the proper one; a general uneasiness pre- 
vails without nausea; no special organ appears to 
blame, and yet in the majority of cases there is a 
general impairment of function. We can accom- 
plish much in improving the general condition by 
the dietetic and hygienic means already laid down; 
but the peculiar nervousness will, in many cases, de- 
mand special prescriptions. Do not resort to opiates 



118 PAINLESS CHILDBIRTH 

or Dover's powders, morphine, or chloral hydrate, 
lest you become habituated to their use. When these 
drugs are used it should be under the supervision of 
a competent physician. 

Dr. Dye's Mitchella Compound is an excellent 
remedy to allay nervousness. An infusion of lady 
slipper or American nervine is often used, with good 
results. Under the influence of either of these medi- 
cines quiet sleep is encouraged and a general improve- 
ment is induced. A pill of asafoetida three times 
daily after food often does much good. When the 
above remedies are employed it is seldom indeed that 
narcotics will be required. 

CONVULSIONS 

It is not best to rely upon unprofessional advice in 
case of convulsions, though until the physician arrives 
the following may be given in teaspoonful doses every 
half hour or hour: 

Bromide of Potash, ... 1 dram 

Bromide of Ammonia, . . 1 dram 

Water, . . . . 1 ounce 

Mix. 

A host of remedies have been tried in this ailment 
and many plans advised, but as professional aid must 
be employed we do not think it best to advise, particu- 
larly as it does not come within the scope of a popular 
work. 

SWELLING OF THE HANDS AND FEET 

The same causes that operate to produce varicose 
veins may give rise to swelling of the feet and hands 
and in rare cases of the whole body. The swelling 
of the extremities will usually be of a dropsical char- 
acter, pitting upon pressure. Obstruction to the return 



REMEDIAL TREATMENT 119 

current of blood through the veins causes an infiltra- 
tion into the cellular tissues of a watery fluid and is 
quite a common ailment of pregnancy. During the 
night or while lying down it usually diminishes con- 
siderably, to reappear when the extremities are 
again placed in the most dependent position. Of course, 
it may be induced by diseases of the heart, liver and 
kidneys, but when these maladies are not present it 
is pretty safe to suppose that it depends upon pregnancy 
and will disappear entirely after delivery. It seldom 
requires any special attention further than what can 
be secured by bandaging as advised for varicose veins, 
the recumbent position, the fruit diet and the use of 
Dr. Dye's Mitchella Compound. I have seen the latter 
perform wonders, almost, in this ailment and it is safe 
and applicable to the general aspects of the woman as 
well as to a special symptom. The free action of the 
kidneys favors relief. There are very many of the more 
vigorous diuretics which can be employed with benefit, 
but as they will be so rarely needed when the hygienic, 
dietetic and remedial measures already prescribed are 
employed I will leave their employment should neces- 
sity for them arise to the physician who sees the case. 
For my own part I have found the directions I have 
already given to be equal to the necessity, even if 
they are simple. 

LEUCORRHOEA 

Leucorrhoea, an exceedingly prevalent affection, is 
usually due to the existence of some disease of the 
uterus or vagina of which it is a symptom. When it 
has existed prior to conception it is very apt to continue 
and often gives rise to very great annoyance from the 
debility, soreness or irritation it causes. 



120 PAINLESS CHILDBIRTH 

The treatment will be essentially the same as when 
it occurs in those who are not pregnant, though instru- 
mental treatment will be inadmissible. Absolute clean- 
liness is essential; the sitz bath is excellent. The de- 
composition of the perverted secretions gives rise 
to .irritation and must be overcome by ablutions, injec- 
tions, etc. 

Injections may be made of tepid water or soap suds 
or they may be medicated. They should be used daily 
or oftener to be of any use, and no force should be 
permitted. An infusion of white pond lily root is an 
injection in which many have great confidence. Carbol- 
ic acid, five grains to a pint of water used at a sitting, 
is an excellent disinfectant and exerts a control over 
the abnormal discharge. Common soda, a teaspoonful 
in a pint of water is good; astringents in the form of 
infusions may be used. Hemlock bark, oak bark, golden 
seal root, crane's bill are all applicable, but should not 
be used too strong. As a rule, an ounce or less to a 
pint of hot water standing till cold and used after the 
proper steps to secure cleanliness will be about the 
strength adapted to the majority of cases. 

The list of remedies for this complaint could be 
greatly enlarged, but as some of them might have a 
tendency to cause miscarriage I have purposely avoided 
them. The discharge being a symptom of disease of 
some portion or portions of the reproductive organs 
the proper time to pay the most attention to its cure 
is when the delivery has passed; hence, simple means 
only are recommended, first and foremost of which 
is cleanliness. 



REMEDIAL TREATMENT 121 

SLEEPLESSNESS— INSOMNIA 

Inability to sleep is particularly annoying to preg- 
nant women and should receive prompt attention, for 
if long continued it may give rise to serious consequences. 
It may be due to lack of exercise or too steady confine- 
ment in heated rooms. Dyspepsia is a common cause 
and should be overcome by a well regulated diet and 
avoidance of late suppers. Tea and coffee may be reck- 
oned among the causes and should not be taken in the 
afternoon or evening by those who are apt to be wake- 
ful. Reading anything exciting in the evening, writing 
or any severe exercise of the mind has a tendency to 
prevent sleep. Incorrect living is the underlying cause 
and to correct it is the first step towards cure, and if 
the cause can be appreciated and understood we shall 
succeed. 

The sleeping room should be well ventilated and 
quiet — neither too warm nor too cold. A regular hour 
for retiring is advisable. A glass of hot milk before 
retiring may aid in inducing sleep, and a warm bath 
taken at ninety to ninety-six degrees just before going 
to bed will often prove a valuable remedy. A rapid 
sponging and rubbing the surface of the body has much 
the same effect. It is not advisable to take opiates if 
possible to avoid them, and for this reason we will not 
give any recipe for them nor for those other abused 
drugs, chloral hydrate, sulphonal and trional. When 
taken let their use be sanctioned and directed by a 
physician who can observe their effects. The remedies 
recommended in the beginning of this chapter usually 
control any unnatural excitement, allay irritability and 
nervousness and produce sleep. 



122 PAINLESS CHILDBIRTH 

CRAMPS— HIP-ACHE— SCIATIC PAINS 

Some women are very much annoyed by cramps or 
spasms in the lower extremities, often worse at night, 
resulting from pressure of the enlarged uterus on the 
sacral nerves. The pain sometimes shoots down the 
thigh as far as the knee or may be localized in the hip- 
joint (hip-ache). Women who suffer from habitual 
constipation or displacement of the womb and those 
in whom the child is large and heavy are as a rule 
more bothered with cramps than others. 

The bowels if constipated must be thoroughly emp- 
tied by laxatives and copious rectal injections of soap- 
suds containing castor oil, Epsom salts, glycerine or 
turpentine. The womb if displaced or tilted should be 
restored to its proper position by a physician. If the 
cramps are due to a large and heavy child the woman 
should wear loose clothing and when lying down should 
turn frequently from one side to the other, so that the 
pressure shall not be too long continued upon those 
nerves that are distributed to one or the other extrem- 
ity, and avoid lying on the back long at a time as that 
position is most apt to bring pressure upon the large 
blood vessels and plexuses of nerves. Frequent changes 
and brisk friction with the hand are better than drugs. 
A properly constructed abdominal bandage so arranged 
as to support the enlarged abdomen and rather lift 
it by straps from the shoulders will often put an end 
to this disagreeable symptom. 

Much benefit often comes from assuming the knee- 
chest position. Pale anemic women will get gradual 
relief as the health improves under the influence of 
fresh air, generous diet and a good iron tonic. Nervous 



REMEDIAL TREATMENT 123 

women should take bromide of potash or asafoetida 
in the way advised in other parts of this book. 

SALIVATION 

When the saliva is formed in such excess as to prove 
annoying, the bowels should be kept quite free with 
Epsom or Rochelle salts, a lozenge containing tannic 
acid or chlorate of potash allowed to dissolve slowly 
in the mouth every few hours, and tincture of iodine 
painted over the salivary glands at the angle of the 
jaw. Bromide of potash taken internally produces the 
best results. 

THE BREASTS AND NIPPLES 

During pregnancy the breasts and nipples should be 
prepared for the very important duty they must per- 
form after the baby is born. They should have ample 
room to grow and enlarge and should be protected from 
pressure or injury. They should be washed twice a 
day with soap and warm water, great care being used 
to remove as gently as possible crusts and branny scales 
from the nipple. After being thoroughly dried they 
should remain uncovered and exposed to the air for 
twenty or thirty minutes. In the last month or two a 
little cocoa butter, castor oil, borated vaseline, cold 
cream or albolene should be smeared over the nipple 
at bedtime to soften the skin. 

If the nipples are small or sunken they should be 
gently drawii out two or three times a day during the 
last month or two of pregnancy, but no unnecessary 
force should be used, as rough manipulation may cause 
cracks or fissures in the nipple. Every effort should be 
used to keep the nipples soft and pliable and no attempt 
should be made to harden them by the use of alum, 
tannic acid, alcohol or other astringent, as was the 



124 PAINLESS CHILDBIRTH 

former custom. In those exceptional cases, however, 
where the skin is thin, tender and sensitive there is 
no objection to the use of witch hazel or the following 
lotion for a week or two: 

Tannic Acid, .... 1 dram 

Glycerine, K ounce 

Rose Water, . . . . M ounce 
Directions — Apply daily to nipples and surrounding skin. 



CHAPTER X 



MISCARRIAGE 

The interruption of pregnancy by the expulsion of 
the child before the seventh month is called a mis- 
carriage or abortion, and when it occurs at any time 
from the seventh month up to about two weeks before 
full term it is known as a premature birth. 

Miscarriages are most likely to occur in the early 
months, usually at a time corresponding with what 
would have been a menstrual period, and often pass 
unrecognized. They are most frequent in women who 
have previously had children. Women who marry late 
in life are more prone to miscarry than those who 
marry early in life. 

Some women are habitually liable to miscarriage 
when they reach a certain stage of gestation, and a 
woman who has been once the subject of this accident 
is much more liable to a repetition of the occurrence 
than one who has not. In early married life the idea 
often obtains that children are not desirable, for some 
reason or other, and not succeeding in preventing con- 
ception a worse crime is resorted to. How many women 
have found to their sorrow that the damage they then 
do lays the foundation for a miscarriage at every 



126 PAINLESS CHILDBIRTH 

succeeding pregnancy. For this reason alone hundreds 
of homes are lonely and desolate. 

CAUSES OF MISCARRIAGE 

Some miscarry at a certain time without any assign- 
able cause. Any violent exertion, anything that occa- 
sions a shock or spasmodic action of the abdominal 
muscles, the irritation of piles, excessive sexual indul- 
gence, a blow, a fall, violent emotion, nursing, riding 
over rough roads, missteps, running a sewing machine, 
stretching the arms above the head, tripping, heavy 
lifting, hot sitz and foot baths, tight lacing, hot vaginal 
injections, abuse of cathartics, disease and displace- 
ment of the womb, affections of the ovaries, the occur- 
rence of fevers and eruptive diseases, excessive vomiting, 
weakness, plethora — any excitement that is capable of 
exciting contraction of the uterus is liable to terminate 
in miscarriage. The occurrence of this accident in 
the first pregnancy is very apt to establish the habit. 

SYMPTOMS OF MISCARRIAGE 

These are rather variable, of longer or shorter dura- 
tion, from a few hours to several days, and the conse- 
quences are equally various. Symptoms that give 
warning of an approaching miscarriage sometimes occur 
and, therefore, when a pregnant woman has more or 
less severe aching pain in the back, nausea or vomiting, 
frequent urination, pains shooting through the bowels, 
languor, uneasiness and a mucous or watery discharge 
from the womb she should remain quiet in bed and send 
for her physician so that prompt and proper treatment 
may be given. 

In the majority of cases hemorrhage or bleeding 
from the womb is the earliest symptom of miscarriage. 
It varies greatly in amount — sometimes being very 



MISCARRIAGE 127 

slight, in other cases so sudden and profuse as to cause 
the greatest anxiety. The bleeding may continue steadi- 
ly or interruptedly for hours or even days before the 
pains come on, and large clots of blood are often passed 
before the foetus is expelled. 

The pains are caused by the contractions of the 
muscles of the womb and at first are usually slight, 
of short duration and recur at long intervals. Later 
on they become more frequent and regular and so 
strong and forceful that, aided by the voluntary expul- 
sive efforts of the woman, the foetus with membranes 
and afterbirth is expelled. Sometimes the pains are 
like those of actual labor and many women have de- 
clared that miscarriage pains are more severe, harder 
to bear and less easily forgotten than those of labor 
itself. The mouth of the womb for physiological 
reasons is not as readily dilated as at the full term and, 
in consequence, more prolonged efforts are usually 
necessary and greater suffering experienced. 

Sometimes the foetus will be expelled with little 
pain, scarcely any hemorrhage and a quick recovery. 
In other cases it may come on with hemorrhage, and 
after a protracted and painful labor the foetus will 
be expelled. The placenta or afterbirth or the mem- 
branes may remain and not come away for several 
da} r s. So long, however, as the placenta or membranes 
or any part of them remains in the womb there is 
danger of hemorrhage and blood poisoning. 

Preceding, accompanying and sometimes following 
the miscarriage there may be alarming hemorrhage. 
It may be internal or external. When external, the 
patient and friends may be deceived until a fatal termi- 
nation is the result. When internal, the patient gets 



128 PAINLESS CHILDBIRTH 

pale and faint, exhausted; the pulse becomes quick 
and thread-like; there will be headache, shivering, 
pain; the abdominal cavity fills up and becomes larger 
than the stage of pregnancy will warrant; after a time 
the membranes give way, the floodgates of life are 
opened and the vital current escapes with a gush. The 
woman may die from internal hemorrhage without its 
escape. The more nearly the woman has approached 
the natural term for delivery the less the danger. Ordi- 
narily, the hemorrhage constitutes the primary danger 
and it usually cannot be perfectly and permanently 
controlled after the progress of the labor has well ad- 
vanced until the contents of the womb are expelled 
and the organ has contracted. The hemorrhage is 
sometimes alarming, profuse, fatal. 

MANAGEMENT OF MISCARRIAGE 

Three indications present themselves from which a 
selection is to be made: 

First, to prevent its occurring, if possible. 

Second, to arrest it. 

Third, to carry the patient safely through the proc- 
ess, provided it cannot be prevented or averted. 

If aware that a patient is in the habit of aborting 
I should advise the hygiene and diet already recom- 
mended and a Mitchella Compound Tabule before 
each meal and at bedtime. This, with perfect rest in the 
recumbent position, a cool room, absolute quiet, a 
calm, unruffled mind, unstimulating food, regularity 
of bowels and the avoidance of sexual relations are 
the essentials of success. 

If we can carry the patient past the fifth month we 
shall generally succeed. Regulate the bowels with some 



MISCARRIAGE 129 

of the means already mentioned and, if the irritability 
of the uterus continues, we must resort to opium — a 
grain in powder or pill every four hours until all pain 
is relieved, to be repeated if it recurs. The action of 
the opium is as positive as anything can be and, 
if the symptoms are active, alternate it with the fluid 
extract or strong infusion of cramp bark. This is as its 
name implies a potent remedy and has stood the test 
of years. It may be given freely. It is said that the 
planters of the South formerly compelled their preg- 
nant slave women to drink an infusion of it in order 
to frustrate their attempts at abortion. When hemorr- 
hage and pains occur together there is very little chance 
of preventing threatened miscarriage. 

Should our efforts fail in preventing the miscarriage 
it must be managed like a case of labor (which see). 
Hemorrhage being the greatest danger, if it becomes 
too free I would give five grains of gallic acid in a wine- 
glass of cinnamon water and repeat as often as may be 
necessary or, if cinnamon water or tea is not at hand, 
I would not wait, but use plain water. Cinnamon is, 
however, valuable of itself. 

Care must be taken to assure the entire removal of 
the placenta and membranes. There will be danger 
until everything "has come away." Should bleeding 
persist or the discharges acquire an offensive odor it 
may be necessary for the physician to scrape or curette 
the womb. 

The greatest possible cleanliness should be observed. 
The external genitals should be frequently washed with 
soap and hot water and an antiseptic solution, and 
diapers and bed linen kept scrupulously clean. A woman 
should receive the same care after a miscarriage as 



130 PAINLESS CHILDBIRTH 

after a full term delivery and should remain in bed 
for ten days or two weeks. If this advice were more 
generally followed there would not be nearly as many 
women suffering from so-called " female weakness." 

It we can ascertain the cause of abortion we can usu- 
ally overcome it or remove the patient from the sphere 
of its operation. 

It is not expected that the unprofessional reader is 
going to rely implicitly upon the directions we have 
given. In cases that are alarming or troublesome a 
physician must be called — one who can determine the 
questions that may present obstacles to others. Our 
wish is to furnish means of prevention, and aid the 
physician in arresting or conducting the process of 
miscarriage. 

Among the results to the mother other than death 
from either accidental or artificial miscarriage are the 
whole train of ailments of the reproductive organs of 
women. Displacements, inflammations, ulcerations, 
deformities, ovarian disorders, leucorrhoea, irritation 
of the bladder, barrenness, mental disturbance, general 
ailments, etc. 

Although many women are subject to these diseases 
who do not miscarry, it is nevertheless true that they 
are the bane of woman's existence. They are often 
regarded as incurable and under the old regime they 
generally were, but in the light of a proper understand- 
ing of the principles of these ailments and the remedies 
at our command I have been able to cure many after 
they had been pronounced incurable by others. 

Abhorring the harsh treatment of the past it will 
doubtless be a source of comfort to many an afflicted 



MISCARRIAGE 131 

woman to know that by properly considering the consti- 
tution, the disease and its complications we can gener- 
ally send medicines to use at their homes that will 
restore them to health. Symptoms are the language 
of diseases and for the most part are intelligible. Know- 
ing this it will place a cure at the disposal of thousands 
who could not travel hundreds of miles to consult the 
physician of their choice. 

Although this may appear incomprehensible to some 
and be opposed by those specialists who can do nothing 
without the " speculum and caustic" it is none the less 
true that applying these principles to practice I am 
constantly curing patients whom I have never seen, 
many miles away. 



CHAPTER XI 



PREPARING FOR CONFINEMENT 
ARTICLES TO BE PROVIDED FOR CONFINEMENT 

To save unnecessary confusion at the time of labor 
every expectant mother should, some weeks before her 
expected confinement, get together those things that 
will be needed for the proper care of herself and her 
child. The following is a fairly accurate list of neces- 
sary articles and it is a good plan to place all of them 
in a specially prepared box or dresser drawer reserved 
for this one purpose: 

1 Rubber sheet or oilcloth as large as the mattress. 

1 Small rubber sheet, 1 yard wide and 2 yards long, 
to be used under the hips. 

2 Porcelain or granite basins. 

1 Porcelain or granite bedpan. 
1 Two-quart fountain syringe. 

1 Pail or slop jar. 
6 Towels. 

2 Water pitchers. 

1 Small bottle of antiseptic tablets (corrosive subli- 
mate). 

1 Pound absorbent cotton. 

1 Can (5 yards) borated or carbolized gauze. 

20 yards sterilized cheesecloth for pads or napkins. 

2 Abdominal binders. 
2 Breast binders. 



PREPARING FOR CONFINEMENT 133 

4 T-bandages for pads or napkins. 
Narrow tape (bobbin) or braided silk for tying the 
cord. 

2 Dozen safety pins (large). 

Castile soap. 

4 Ounces whiskey or brandy. 

4 Ounces lysol. 

4 Ounces saturated solution of boracic acid. 

4 Ounces Cacao butter, sweet oil or albolene. 

1 Small blanket in which to place the baby. 

1 Crib or basket for the baby. 

Baby clothing. 

CONFINEMENT OR LYING-IN ROOM 

The average confinement occurs in the room ordi- 
narily occupied by the expectant mother as a bedroom. 
But when a choice of several rooms can be made it 
is advisable to select one that is large, easily ventilated 
and with a sunny exposure. An open fireplace is very 
desirable. The nurse should see to it that the room 
is at all times pleasant and cheerful and that all unnec- 
essary draperies and furniture are removed. A confine- 
ment should never occur in a room recently occupied 
by a person suffering from scarlet fever, measles, ery- 
sipelas or other contagious or infectious disease unless 
the room has been thoroughly fumigated and disin- 
fected. 

CLOTHING WORN DURING LABOR 
When symptoms of labor appear, the woman should 
take a tub or sponge bath and change all her linen. 
A clean nightgown should be put on and, over 
it, during the first stage, a loose wrapper or kimona. 
The chemise and nightgown should button in front 
and not be too long, so that they can be readily changed 



134 PAINLESS CHILDBIRTH 

when soiled. No clothing should be worn suspended 
by bands at the waist. 

THE CONFINEMENT BED 

When it can be had, a lounge or cot-bed properly 
arranged is the most convenient couch on which de- 
livery can take place, for it permits to the best possible 
advantage the assistance of the attendants; can be 
readily moved to suit any necessity, and preserves the 
bed in which she must subsequently lie dry and com- 
fortable. This temporary bed should be moderately 
hard and firm, so that it may not sag downward beneath 
the hips of the woman; the head should be a little 
the highest, and the foot provided with a convenient, 
narrow footboard at an agreeable angle of inclination, 
against which she may press with her feet during her 
expulsive efforts. A sheet should be twisted into a cord 
and fastened to the foot-piece for her to grasp in her 
hands and pull upon during the " bearing down pains. " 
It is needless to add that this temporary bed should 
be of sufficient width for convenience, that she may turn 
herself from one position to another to lessen the 
fatigue of unnecessary restraint. 

HOW TO PREPARE THE BED 

The large rubber sheet is placed on the mattress 
and tightly pinned at each corner. This is covered 
with a linen or cotton sheet and also a draw-sheet 
tightly tucked under the mattress. Over the draw-sheet 
are placed the small rubber sheet and a second draw- 
sheet (made by folding an ordinary sheet into four 
thicknesses) that should be tightly pinned at each 
corner so that it may not be easily pulled out of place. 
After labor, the small rubber sheet and the upper draw- 
sheet can be easily removed with the other soiled clothes. 



PREPARING FOR CONFINEMENT 135 

THE ABDOMINAL BINDER OR LYING-IN BANDAGE 

Though some physicians declare that the bandage 
or binder is useless or even harmful, we always advise 
that one be put on, because if properly fitted it certainly 
adds to the comfort of the newly-made mother by over- 
coming the feeling of emptiness that exists after the 
baby is born. Two of these binders should be made 
from unbleached cotton or muslin some weeks before 
confinement. The binder should be a yard and a quar- 
ter long and half a yard wide or wide enough to reach 
from the hip bone to the lower part of the breast bone. 
When first put on it should be pinned from below up- 
ward and be fairly tight. When there is any tendency 
to excessive hemorrhage or flooding, a pad or compress 
made of two or three folded towels should be placed 
over the womb beneath the binder. The binder is 
rarely needed after the first week or ten days. 

THE BREAST BINDER 

A binder or bandage is often needed to make pres- 
sure on the breasts or to hold poultices, fomenta- 
tions or other applications in place. The Murphy 



FRONT ^ ' BACK 2tng/„ FRONT 

FHONT ARMH0 LL ARMUOL€ 



Figure 11 

breast binder is an excellent one, and is made from 
a double fold of muslin long enough to go around 
the body and wide enough to reach from the neck 
to the waist. The edges should be stitched and 



136 



PAINLESS CHILDBIRTH 



on one edge notches cut for the neck and each arm. 
Small safety pins are used to pin it in front and over 
the shoulders and to form darts under the breasts. 

A breast bandage made like a Y from three toilet 
napkins is preferred by many. Pin two napkins to- 
gether to form a V and fasten them to the middle of 
one end of the third napkin. Pass the single napkin 
across the back; carry the two napkins over the chest, 
one above and one below the breasts, and pin to the 
single napkin. This bandage is often used to support 
or hold up the breasts. 

BABY'S BASKET 




Figure 12 

It is a great convenience to have a basket or box in 
which to place all those things needed for the care and 



PREPARING FOR CONFINEMENT 



137 



toilet of the baby. Many stores carry many different 
styles of such baskets, but one that will prove in every 
way suitable can be easily and cheaply made at home. 
A basket with a lid — hamper style — 2^ feet long, 15 
inches wide and 8 inches deep, is about the right size, 
and when covered and lined with some dainty materi- 
al is both attractive and useful. Pockets may be placed 
at the corners and a pincushion on the under side of 
the cover. 

The basket should contain the following articles: 
Castile soap, bath thermometer (Fig. 13), pincushion, 




Figure 13 

several sizes of safety pins, washcloths, powdered 
stearate of zinc, toilet powder, bottle of pure olive or 
sweet oil, jar of cacao butter or well washed lard, 
solution of boracic acid, absorbent cotton, some old 




Figure 14 
linen handkerchiefs or pieces of soft linen, baby comb 
and brush, infant's syringe (Fig. 14), medicine 
dropper (Fig. 15). 



Figure 15 



138 PAINLESS CHILDBIRTH 

BABY'S BATHTUB 

A large porcelain basin will answer very nicely for 
baby's first sponging, but for later baths a porcelain 
or white enamel baby bathtub should be provided. 

BABY'S WARDROBE 

The quality and amount of clothing will necessarily 
vary according to circumstances, and the following list 
is therefore intended simply as a guide to the expect- 
ant mother : 

2 Flannel binders 18 inches long and 5 inches wide, 
with pinked edges. These are used for the first two 
months. 

2 Knitted bands with shoulder straps. They should 
be made of wool in the winter time, of cotton in summer. 

6 Shirts — wool for winter, cotton for summer. 
4 Flannel petticoats. 
4 Muslin petticoats. 
8 Slips or dresses. 

6 Nightgowns made of light weight flannel. 
6 pairs socks. 

4 dozen diapers of cotton diaper cloth. 
2 Flannel or knitted blankets for wrapping about 
the baby. 

BABY'S BED 

A wicker bassinet or even a clothes-basket is the 
best bed for a new-born infant. The possibility of 
the child being smothered or rolled upon and the harm 
that might result from too frequent nursing consti- 
tute strong reasons why the babe should not sleep in 
the same bed as the mother. When the baby is four 
months old it may be placed in its own bed or crib. 



PREPARING FOR CONFINEMENT 139 

The hair mattress should be protected by a rubber 
sheet on which is placed a bed pad made of a yard- 
square piece of mattress covering. The bed sheet 
should be large enough to allow it to be well tucked 
under the mattress. The pillow should be of fine 
curled hair and large enough to support both head and 
shoulders. Light-weight flannel blankets and wool or 
cotton comforters will be all the bed covering that is 
required. Good habits should be taught from the first, 
and the baby should not be taken up every time it 
cries nor quieted with so-called soothers, pacifiers 
or hushers. 



CHAPTER XII 



MANAGEMENT OF LABOR 

At the expiration of nine calendar or ten lunar or 
menstrual months or, more definitely, two hundred and 
eighty days after conception the foetus having advanced 
far enough in physical development to maintain an 
independent existence is separated from the mother by 
a natural process termed labor or childbirth. 

It is possible for the foetus to survive if this process 
should occur at an earlier period, and instances are 
not uncommon of survival at the end of the seventh 
month or even earlier, and instances are reported 
where the infant has survived birth at the end of five 
months; but it must be conceded that such cases are 
extremely rare. 

When labor occurs before the end of the ninth month 
it is said to be premature. 

On the other hand we have abundant and well 
authenticated evidence to show that pregnancy may 
be protracted beyond the customary period of two 
hundred and eighty days without any serious detri- 
ment to either mother or child. It ordinarily occurs 
within a few days of the average time. The laws of 
nature, however, are not absolutely invariable, and 



MANAGEMENT OF LABOR 141 

no harm need be apprehended should the deviation 
amount to two or three weeks. 

Considerable difference of opinion exists among 
scientific physicians regarding the extreme limit of 
variation. The French have enacted in their Code 
Napoleon that a child born within three hundred days 
after the death or departure of the husband, or one 
hundred and eighty days after marriage, shall be de- 
clared legitimate. This code admits that the legiti- 
macy of a child born beyond three hundred days may 
be contested. In America, however, no fixed or stated 
time is made and each case must be settled on its 
own individual merits. 

Prof. Meigs published a case, which he regarded 
as trustworthy, of the prolongation of the pregnancy 
to four hundred and twenty days or sixty weeks — fourteen 
months — or five months beyond the ordinary term. I 
merely mention the fact without any expressions of be- 
lief or doubt. Prof. Atlee mentions two cases of prolon- 
gation to three hundred and fifty-six days. Out of 
one hundred and sixty cases Dr. Elasser found that 
eleven were protracted to a period varying from three 
hundred to three hundred and eighteen days. Sir 
James Y. Simpson mentions four cases in his own 
practice in which pregnancy was protracted to three 
hundred and thirty-two, three hundred and twenty- 
four and three hundred and nineteen days respectively. 

The time elapsing between the end of the seventh 
month and delivery appears to be more for the pur- 
pose of perfecting such foetal development as has been 
already begun than for any new development essential 
to the maintenance of life. During this time the vari- 
ous organs become more capable of carrying on the 



142 PAINLESS CHILDBIRTH 

functions for which they were destined, and it is during 
this time that the greatest proportionate increase in 
size and weight occurs. 

WHY DOES LABOR OCCUR AT THE END OF THE 
NINTH MONTH ? 

The cause of labor at this particular period is 
shrouded in more or less of mystery, yet the opinion 
seems to be gaining ground that it is due to changes 
in the structure of the placenta and its membranes 
or as they are more commonly called the afterbirth. 
The foetus being capable of maintaining its independ- 
ent existence, the destiny of the placenta as a connect- 
ing link between mother and child has been fulfilled 
and it undergoes retrograde metamorphosis — fatty 
degeneration — its attachments to the walls of the 
uterus are gradually severed and the separation has 
been so far completed by the end of the ninth month 
that its expulsion as a foreign body becomes neces- 
sary, which is effected by the uterine contractions im- 
mediately or very soon after the birth of the child to 
which it is yet attached by the cord. 

A PHYSICIAN SHOULD ALWAYS BE PRESENT 

In the following directions for conducting a labor 
it is not presumed to interfere with the duties of the 
medical attendant who should be present from the 
beginning to the completion of ,the process. Neither 
is it expected that the readers will assume the respon- 
sibility of management, but it is hoped that by these 
and the foregoing directions the patient and physi- 
cian may be aided, the labor rendered short, safe and 
easy. 

PREMONITORY SYMPTOMS OF LABOR 

These are generally manifested for a period of time 



MANAGEMENT OF LABOR 143 

varying from one to two days to as many weeks. Sub- 
sidence of the abdomen is one of the most prominent. 
The stomach and lungs being greatly relieved of the 
pressure which they have borne for some time, the 
sense of oppression occasioned by this pressure disap- 
pears and the woman feels unusually well, buoyant 
and light. This symptom is known as " lightening' ' 
and may be so deceptive that she will venture abroad, 
and perhaps by her unusual efforts induce labor under 
ludicrous and annoying circumstances. Women who 
have borne children attach considerable importance to 
this sign. Another sign is an increased fullness of the 
external parts and a discharge of mucus from the 
vagina that is sometimes tinged with blood and may 
become so profuse as to necessitate the employment 
of a napkin. This is known as the "show." The dis- 
charge is an important sign, particularly if accom- 
panied by a chill and the fullness 61 the parts above 
mentioned, and is usually followed by labor in the 
course of twenty-four hours. There may be painless 
uterine contractions and a sense of anxiety experienced, 
fidgetiness, sometimes a depression of spirits and other 
symptoms of less importance. 

SYMPTOMS THAT SHOW THAT LABOR HAS 
COMMENCED 

Indications that labor has begun are at first more 
or less variable and deceptive. There is apt to be a 
desire to pass urine frequently and evacuate the bowels. 
In many cases there will be a marked chill. The " show " 
to which reference has already been made is a symptom 
of great value, as it is soon followed by the "pains" 
which recur periodically at intervals of an hour or 
less. These pains may be false or true. 



144 PAINLESS CHILDBIRTH 

False Pains. — In the last week or two of preg- 
nancy false pains often annoy women, especially those 
who have previously borne children. They sometimes 
closely resemble actual labor pains, but they have a 
tendency to constantly shift from one part of the 
abdomen to another, are not attended with any in- 
crease of the vaginal discharge nor any dilation or 
opening of the mouth of the womb. A dose of castor 
oil, a soap-suds enema, a hot bath or drink will often 
cause them to disappear. 

True Labor Pains, on the other hand, commence 
in the lower part of the uterus; are first felt in the 
back and gradually extend to the front and into the 
thighs, recurring with regularity and increasing sever- 
ity, power and frequency, until having attained their 
greatest intensity they remain stationary a moment 
and then subside, and are followed by an interval of 
repose. They dilate the neck of the uterus and pro- 
trude its contents. During the continuance of a "true" 
pain if the hand is placed upon the abdomen over the 
uterus this organ will be felt contracting and becoming 
harder with the pain as it advances and to become 
softer again as the pain passes off. 

Having already pointed out the means by which 
the pains of childbirth are to be avoided and using 
the term pain so freely in this chapter may seem 
rather inconsistent or paradoxical, but it is only appar- 
ently so. Heretofore we have used the term pain 
to indicate distress and suffering, but in this connec- 
tion we use the term to signify uterine contraction 
which, as has already been shown, may be painless. 
The reason for this paradox is that by common con- 
sent the word "pain" in obstetrical parlance is used 



MANAGEMENT OF LABOR 145 

synonymously with uterine contraction which is, under 
ordinary circumstances, attended or immediately fol- 
lowed by suffering more or less severe. With this 
explanation the author hopes to be forgiven if he con- 
tinues to use the term according to custom. 

True labor pains exhibit different characteristics, 
according to the stage of the process. At first they 
are " cutting" or " grinding," short, severe, situated 
in the back, extending to the abdomen, loins and 
thighs, and are confined to the first stage of labor 
while the neck or mouth of the womb is dilating to 
admit of the exit of the child. As the first stage changes 
to the second, the pains become " forcing" and " bear- 
ing down." The woman can no longer conceal them if 
she should wish to, but involuntarily she aids them 
with expulsive and straining efforts. During the first 
stage the suffering may be considerable if any abnormal 
condition exists, and the patient will be apt to be irri- 
table, restless, peevish and perhaps despondent; she 
desires to be constantly changing position, but as the 
pains become more forcing in character this condition 
passes off, and instead of wishing to avoid or retard 
them she involuntarily does everything in her power 
to aid them. 

THE EXAMINATION 

Any question that may arise during the progress 
of the labor is to be settled by the medical attend- 
ant, and as early as possible after the labor has begun 
a thorough vaginal examination should be made by 
him with a view to determine the progress of the labor 
and the presenting portion of the child. It should be 
made early, so that any malposition may be corrected 
before advancement renders it difficult. Frequent 



146 PAINLESS CHILDBIRTH 

examinations are unnecessary, increase the danger of 
infection and are often obnoxious to the lying-in woman. 

THE PATIENT'S POSITION DURING LABOR 

During the progress of labor the position of the 
patient is one of considerable importance, yet I do 
not believe in compelling the patient to remain in 
any one position. During the first stage of labor there 
is no good reason why she may not remain up and about 
the house if she chooses, and even when the delivery 
takes place the position is more a matter of choice 
and convenience than necessity. Nearly all works on 
the subject of midwifery mention the position on the 
left side as the desirable one, and some attendants 
insist that the woman occupy this position from the 
beginning of the second stage of labor to its comple- 
tion. So far as my observation goes, few women select 
this position themselves. Some will get upon their 
hands and knees upon the floor, a few in various other 
positions; but by far the largest proportion prefer 
lying upon the back with the head elevated, the knees 
bent, the feet braced and the hands grasping some- 
thing upon which they may pull during their expulsive 
efforts. The safety of the child and the attention the 
mother will immediately require are the most impor- 
tant considerations to be observed in the selection of 
position, and there is little or no objection to a frequent 
change of position up to the last moment if they desire. 

QUIETNESS, SYMPATHY AND ENCOURAGEMENT ARE 
ADVISABLE 

The room is to be kept as quiet as possible— not 
too dark nor too light — and at a temperature most 
agreeable to the patient. Too many persons should 
not be allowed in it, and those should be the ones 



MANAGEMENT OF LABOR 147 

chosen by the patient herself beforehand and should 
be selected on account of their confidential relations 
to her, their sympathy, good sense, experience and 
endurance. No conversation should be permitted 
that is disagreeable, exciting or depressing. She needs 
sympathy, encouragement, confidence and fortitude. 
Nothing can be worse than to have those upon whom 
she relies filling her mind with fear or discouragement. 
Their sympathy must never permit them to give vent 
to sorrow by expressions of grief. 

FIRST STAGE OF LABOR 

If, during the first stage of labor, the examination 
reveals the mouth of the womb hard and rigid and 
not dilating as it should, pain frequent and torment- 
ing, I would expect speedy relief to follow the adminis- 
tration of the following prescription: 

Fluid Extract Gelseminum, . 15 drops 

Fluid Extract Lobelia, . . 15 drops 
Water, ..... 2 ounces 

Dose — A teaspoonful every fifteen minutes until relieved. 

It not unfrequently happens when this is the case 
that nausea and vomiting occur, which seems to be 
nature's method of overcoming this opposing rigidity 
and exciting the mucous secretions for the purpose of 
lubricating the passage and expediting delivery. 

The bowels should always be freely unloaded before 
the labor has progressed very far, and for this purpose 
the employment of an injection of warm water is ap- 
propriate. To wait for a cathartic is often out of the 
question, and the physician who reads this will doubt- 
less appreciate the advice to use the injection, partic- 
ularly if he has ever attended a case in which the 



148 PAINLESS CHILDBIRTH 

operation of a cathartic and the termination of labor 
occurred about the same time. 

Nature usually provides for the lubrication of the 
maternal passages by an abundant secretion of mucus, 
together with the "waters," and care should be taken 
that the bag of waters is not broken too early, as a 
dry birth may be the result. N 

During the first stage the ordinary diet may be 
allowed and, at last, such warm drinks as she may 
desire. 

Much harm is often done by advising the woman to 
"bear down" and make expulsive efforts too early, 
by which she is only worn out and exhausted without 
accomplishing advancement. Until the womb has been 
dilated to admit of the passage of the child no amount 
of expulsive effort on the part of the mother will avail. 

SECOND STAGE OF LABOR 

It is wrong to rupture the "bag of waters" until 
this dilation has been effected, for it acts as a wedge 
that prepares the passages and advance of the child. 
It is usually ruptured at the beginning of the second 
stage and comes away with a gush. If it is ruptured 
before dilation occurs it will have a tendency to retard 
the labor. If it is not ruptured spontaneously after 
the womb is well dilated and the labor well advanced 
this can be easily done with the finger nail. There 
is more danger of rupturing it too early than too late, 
and for this reason interference should be well con- 
sidered before undertaken. These remarks are intended 
more particularly for the unprofessional, though we 
know of some physicians who would do well to consider 
them. It is presumed, however, that the physician in 
attendance will know his business and exercise his 



MANAGEMENT OF LABOR 149 

judgment, to which bystanders are expected to yield. 
There are some cases where the labor will proceed to 
a termination in his absence, and in such cases the 
full force of this chapter must apply. 

As the labor nears its termination the pains are apt 
to become more protracted and forcible and often 
more frequent, and are sometimes attended by cramps 
in the limbs. These latter may usually be relieved by 
friction. An examination will reveal the presenting 
part of the child pressing upon the perineum or floor 
of the pelvis, where it may be felt to advance and re- 
cede with each pain, gaining a little each time. 

The exertion now reaches its greatest height, the 
soft parts dilate and yield; one pain follows another 
in rapid succession, so that one begins almost before 
its predecessor has terminated, until, with a mighty 
effort, the head is expelled, after which a short rest 
may occur, then with one or two more efforts the birth 
is accomplished. 

Nearly all obstetric writers give explicit directions 
for supporting the perineum during the last few pains, 
with a view to prevent it from being ruptured. The 
support should be gentle and not retard the labor, 
but merely to aid the perineal muscles in directing 
the head of the child in the axis of the natural outlet 
without tearing through the tissues. The support 
must be gentle, even and constant. 

Sometimes it happens that when the labor is well 
advanced the efforts become less powerful and may be 
suspended altogether, owing to muscular exhaustion. 
It is then that certain remedial agencies may be called 
into requirement, and the question for the physician 



150 PAINLESS CHILDBIRTH 

to determine is whether he shall employ forceps to ex- 
tract the child or whether he shall make use of means 
to stimulate uterine contraction and thus effect de- 
livery. It will be very seldom indeed that those who 
have carried out the advice given in previous chapters 
of this book will require a practical solution of this 
question. 

When, however, such an emergency shall arise, five 
to ten grains of the sulphate of quinine will usually 
be adequate, and more particularly if her muscles are 
naturally very feeble. 

The black cohosh, cimicifuga or macrotys as it is 
variously called possesses similar qualities, and from 
ten to twenty drops of the saturated tincture or fluid 
extract may be given every twenty minutes until the 
expulsive efforts are resumed. This latter remedy is 
open to one objection when given in sufficient quantity 
to produce this effect, and that is that it is liable to 
cause an unpleasant fullness and pressure in the head. 

As soon as the head of the child has made its exit 
the mother experiences sensible relief and may be as- 
sured that the worst is over. The whole body may 
follow at once, but usually there is a short pause, when, 
the body turning sideways, it is expelled by another 
contraction. 

If the short interval that occurs between the expul- 
sion of the child's head and the rest of the body is 
protracted beyond two or three minutes, manual assist- 
ance should be rendered. Friction and firm pressure 
over the womb is to be made, and inserting a finger 
into the child's arm-pit, slowly extract it. No other 
course is left. Do not hasten too much lest you favor 



MANAGEMENT OF LABOR 151 

hemorrhage. Do not delay too long or you endanger 
the child. 

When the head has made its exit, the nurse or some 
assistant who has been previously instructed should 
make gentle pressure upon the uterus with her hands 
and follow it down as it contracts, and keep up the 
pressure firmly. When this is properly done it will 
secure the necessary contraction of the uterus, the 
afterbirth will be quickly expelled and no trouble from 
hemorrhage will be liable. When flooding occurs in 
such cases it is usually because the uterus does not 
contract and close the blood vessels, consequently the 
importance of the advice relative to the pressure upon 
and grasping, as it were, the uterus as the child is 
being expelled is obvious. 

As soon as the head is born it should be immediately 
ascertained if the cord be wound around its neck or 
not, and if it is it must be loosened, for if this is not 
done the child may be strangled. Immediately after 
the child is born it is to be laid on the right side, its 
face free and exposed to the air, its mouth examined 
and freed from any mucus that may have accumulated 
which will otherwise interfere with respiration. 

When there is no trouble about the child a few mo- 
ments suffice to secure its separation and removal. 

THIRD STAGE 

If the pressure before mentioned has been properly 
carried out, the uterus will have contracted and de- 
tached the afterbirth and it may be already expelled; 
but if it has not, and the flooding does not demand 
attention, the mother may be permitted to rest a few 
minutes before making any efforts to extract it 



152 PAINLESS CHILDBIRTH 

If, after waiting half an hour, there are no after- 
pains — friction upon the abdomen, grasping the uterus 
with one hand through the walls of the abdomen and 
gently kneading it is to be resorted to. Should these 
means fail it is possible that the afterbirth is adherent 
(grown fast) and the physician may have to remove it. 

When the hemorrhage is too profuse, give ten grains 
of gallic acid in a tablespoonful of water, or a teaspoon- 
ful of fluid extract of ergot, at once. A douche of plain 
hot water or equal parts of hot water and vinegar will 
also help in contracting the blood vessels and checking 
the bleeding. 

HOW AND WHEN TO TIE THE CORD 

As soon as the child cries — and it is generally sure 
to find out its abilities to do so very quick — the cord 
may be severed, and the birth, so far as the child is 
concerned, is complete. If the cord is free from the 
neck and cannot be felt to pulsate it should be severed 
at once, whether the child cries or not. If it does not 
cry, artificial respiration is to be resorted to immediately 
as described below. For tying the cord, narrow tape 
(bobbin), braided silk or other material suitable for a 
ligature may be used. The cord should be tied in two 
places — the first ligature being tied tightly around the 
cord about one inch from the child's body, the second 
an inch or two further from the child. With a pair 
of clean, sterile scissors cut the cord between the two 
ligatures, taking the oft-reiterated precaution to see 
that no part of the child is cut at the same time. 

Several homeopathic writers have advised against 
tying the cord at all, but severing without, as soon as 
the pulsation ceases. When the cord is severed, if the 
child breathes it is to be wrapped in a warm flannel 



MANAGEMENT OF LABOR 153 

blanket prepared for its reception and handed to 
the attendant upon whom the duty devolves of washing, 
dressing and making it presentable. 

If there is any delay in the child's breathing after 
birth, let the cool air come upon its skin, which is a 
natural excitant of respiration, or blow in its face or 
mouth or dash a little cold water on the face or chest, 
slap it briskly upon the back and buttocks and apply 
brisk friction all over it. When there is much mucus 
in the throat remove it by the finger covered with a 
piece of clean cheese cloth or soft linen. Be careful, 
however, that it does not become chilled and thus 
destroy its life. If this does not answer, inflate the 
lungs by blowing in its mouth and then forcing out 
the air by pressing the chest, and repeat till it gasps. 
Grasping it by the ankles and swinging it with the 
head downward has been recommended as an efficacious 
plan of restoring suspended animation. 

THE PLACENTA OR AFTERBIRTH 

This is a very important organ, because through it 
the developing child receives its nutriment during its 
life in the womb, and in it the blood of the child mixes 
with that of the mother to be oxygenated and purified. 
It is expelled after the birth of the child and should 
always be carefully examined to see that it has come 
away intact and unbroken. The placenta looks like 
a large flat cake, about 7 or 8 inches in diameter, and 
weighs about 13^ pounds. The outer or maternal sur- 
face is rough with furrows and grooves; the internal 
surface is smooth and has the cord inserted near its 
center. The edges are continuous with the membranes 
or bag that held the water in w T hich the child floated 
during its life in the womb. 



154 PAINLESS CHILDBIRTH 

THE UMBILICAL CORD 

The cord extends from the child's navel to the center 
of the inner surface of the afterbirth. It is usually as 
thick as your little finger and about 20 inches long, 
but may be anywhere from 3 to 70 inches. When very 
long, the cord is liable to form loops around the baby's 
neck or limbs. It is often twisted and in a few rare 
cases knotted. 

CLEAN CLOTHES AND CLEAN BED FOR THE NEWLY 
MADE MOTHER 

When the afterbirth has come away, all soiled and 
blood-stained clothing and bed linen are removed, the 
mother's body washed thoroughly clean and the geni- 
tals bathed in an antiseptic solution (one teaspoonful 
of lysol to one quart of water). For a wash-rag a piece 
of cheese cloth previously cleaned by boiling is better 
than a towel or sponge. When everything has been 
made absolutely clean and dry, a soft, warm and clean 
napkin is placed over the genitals, and the binder 
snugly and evenly arranged and pinned — the safety 
pins should be about 13^ inches apart and the pinning 
should be from below upwards. Warm, clean under vest 
and nightgown are now put on the mother, a draw- 
sheet under her hips and clean linen on the bed. She 
may have a glass of milk or a cup of weak tea (not too 
hot). The room is slightly darkened and if everything 
be quiet she will likety go to sleep. No visitors should 
be allowed in the room, and the baby if it cries should 
be taken to another part of the house. Sleep is nature's 
great restorer, and the newly-made mother will be 
greatly refreshed by a few hours' sleep and rest. 

WASHING THE NEW BABY 

This should be done carefully and systematically. 
Everything should be got ready before starting to 



MANAGEMENT OF LABOR 155 

wash the baby. The room should be warm — about 
76° F. — and all doors and windows closed to avoid 
draughts. A folding screen placed around the nurse's 
chair adds further protection. The infant should lie 
in a blanket on the nurse's lap and but one part of 
the body exposed at a time. The eyes are first attended 
to. The physician should instill one drop of Crede's 
solution (2% solution of nitrate of silver) into each eye. 
A small pad of absorbent cotton soaked in a solution 
of boracic acid (20 grains of boracic acid to one ounce 
of distilled water) is used to clean the eyes and wipe 
away all secretions. The mouth is cleansed with a soft 
cloth dipped in the same solution and wrapped around 
the nurse's little finger. The whole face is now washed 
with plain warm water without soap. To remove the 
cheesy substance known as the vernix caseosa the rest 
of the infant's body is greased or rubbed all over with 
olive oil, sweet oil, white vaseline, cocoa butter or lard 
freed from salt by a thorough washing in water. Next, 
the body is washed with water and castile or glycerine 
soap, care being taken that the soap does not get into 
the baby's eyes. The scalp, armpits, groins, backs of the 
knees and ears should receive the closest attention. 
After the body is thoroughly washed, the baby is dried 
by gently patting the skin with a very soft towel and 
then powdered with plain corn starch or a good talcum 
powder. No unnecessary friction or rubbing should be 
used, because the baby skin is very tender and easily 
injured. 

The wash rag should consist of a piece of soft linen 
or cheesecloth that has been previously thoroughly 
cleaned by boiling. The washrag used in the first 
washing should be destroyed. 



156 PAINLESS CHILDBIRTH 

HOW TO DRESS THE CORD 

After being thoroughly washed and dried it is dusted 
with a little powdered boracic acid, wrapped in steri- 
lized gauze or cotton, turned upwards a little to the 
left and held in place by the binder. The cord usually 
dries, withers up and drops off about the fifth day, but 
no force should at any time be used to effect its removal. 
After the cord has come off, a pad of antiseptic gauze 
should be placed over the navel and held firmly in 
place by the binder to prevent hernia (rupture). This 
should be continued for about one month. 

DRESSING THE BABY 

The clothing should be loose and easy. The material 
should be light in texture, warm and unirritating. The 
binder should be made out of soft flannel cut on the 
bias and unhemmed. It should be about 6 inches wide 
and 20 inches long. A flannel undershirt without 
sleeves and opening in front, a flannel slip, a muslin 
slip, socks and diaper are all the clothing that is needed. 
The feet and legs should be kept warm, as cold feet 
often cause colic. The slips should be fastened with 
tapes — not with hooks, buttons or pins. 

At night the slips are removed and a light flannel 
nightgown hung from the shoulders put on. The weight 
and amount of clothing should vary with the tempera- 
ture and season of the year. 

THE FIRST NURSING 

After the mother has had a few hours' rest, the baby 
is put to the breast. There are two good reasons why 
this should be done. The first one is that by a reflex 
nervous or sympathetic action suckling at the breast 
causes the muscles of the womb to firmly contract, 
and so lessen the danger of flooding. The second reason 



MANAGEMENT OF LABOR 157 

is that the mother's breast at this time contains a se- 
cretion known as colostrum that it is very desirable for 
the child to have, as it acts as a laxative and promotes 
the expulsion of the " meconium " — a tarry substance 
found in the bowels of a new-born child. 

No difficulty is usually experienced in getting the 
baby to nurse, but sometimes, when the baby is feeble 
or the nipple small, some tact may be needed. Such 
babies should be taught to nurse before the milk 
" comes in" on the third day. The nipple can be moist- 
ened with a little milk squeezed from the breast or 
with sweetened water. 

If the nipple is not prominent enough to enable the 
child to grasp it, it may be drawn out by taking a 
bottle and filling it with hot water or dipping it in hot 
water and applying it over the nipple. As it cools, a 
sufficient degree of suction will occur to draw out the 
nipple, then apply the child immediately. 

On the first day the baby should be nursed every 
six hours; on the second, every four hours. During 
these two days more frequent nursings are unneces- 
sary and may be harmful. If the baby cries too much 
one or two teaspoonfuls of moderately hot water will 
usually satisfy it. On the third day regular two-hour 
feedings are started, as described in a later chapter. 

ANAESTHETICS DURING LABOR 

If anaesthetics may be used to prevent pain in surgi- 
cal operations the question very naturally arises : Why 
may they not be equally appropriate for the prevention 
of pain at childbirth? 

Various objections to their employment have been 
urged, the principal one of which is that when the 
patient is under the anaesthetic influence the uterine 



158 PAINLESS CHILDBIRTH 

contractions are suspended and the labor arrested. 
Theoretically this objection appears plausible enough, 
but it is not sustained by practice. 

Obstetricians who have made this question the sub- 
ject of special study assure us of the safety of anaes- 
thesia properly managed, and that suspension of uter- 
ine contraction under their use is the exception instead 
of the rule. I have myself repeatedly administered 
chloroform in parturition, and instead of prolonging 
the labor I have every reason to believe that it was 
materially shortened. Under the influence of the drug 
the irritability of the nervous system was diminished, 
and those wearing, cutting, irregular and inharmonious 
pains that so often prevail and cause so much suffer- 
ing and annoyance were suspended, and instead of 
expending the energies of the woman the natural pains 
become more regular and efficacious. 

In administering the anaesthetic I endeavor to secure 
as near as possible, that state of semi-unconsciousness 
in which the sensation of pain is nearly or quite sus- 
pended, without inducing that profound anaesthesia 
that interrupts all muscular action. A good way to 
accomplish this is to render the inhalation intermit- 
tent, to correspond as near as may be with the occur- 
rence of the pains, renewing the inhalation at the 
commencement and withholding it during the interval. 
By this method the objections urged by many against 
the use of chloroform in parturition are obviated. We 
do not suspend natural contractions, although we afford 
the necessary relief without any danger of charging 
the blood to the extent of endangering the life of the 
child. 



MANAGEMENT OF LABOR 159 

I do not wish to be understood that anaesthetics 
cannot suspend labor; such a position would be ex- 
tremely ridiculous, for it is known that anaesthesia 
may be so profound that all involuntary action may 
be suspended, the heart and respiration cease and death 
result; but I do assert that when the anaesthetic is 
employed to induce partial insensibility that uterine 
contraction will not be impaired. I am well convinced 
that the realization of pain will cease under the admin- 
istration of an anaesthetic before muscular contraction 
is suspended, and I know from clinical experience that 
the administration of chloroform or ether may be so 
managed as to overcome pain and not prolong labor, 
and that if all other means were to prove fruitless with 

THESE AGENTS WE MAY MAKE CHILDBIRTH ABSOLUTELY 
PAINLESS. 

Few, indeed, are the accidents that are known to 
have occurred from the use of chloroform in child- 
birth, and the use of anaesthetics in midwifery practice 
is justly deemed the least dangerous occasion for their 
employment. Various theories have been advanced to 
account for this fact, the most plausible of which, to 
my mind, is that the partial degree of anaesthesia neces- 
sary for the purpose cannot be as dangerous as the 
profound insensibility necessary in surgical operations. 
There is no need to discuss the other theories in this 
work. The facts that labor can be rendered painless 
by such means, even when every other plan has failed, 
and that the danger is trivial, are of far more conse- 
quence to the woman. 

I am supported in my belief by the experience and 
observation of such men as Sir James Y. Simpson, 
Dr. Tilt, Dr. W. P. Johnston, H. R. Storer, Dr. Beatty 



160 PAINLESS CHILDBIRTH 

and others, that when there is not some valid reason 
for withholding it the proper employment of anaesthe- 
sia is far less harmful than the suffering that too often 
occurs at such time. 

When the patient is healthy and robust, the suffer- 
ing inconsiderable and the labor promising to be short, 
I should certainly refuse to give the anaesthetic, 
simply because there would be no necessity for its 
administration; but in a weak and feeble woman, 
suffering intensely, her pain torturing her to no effect, 
the suffering endangering exhaustion, I would not 
hesitate for a moment; I would administer the agent 
in confident expectation of relieving her agony, pre- 
venting prostration, regulating the uterine contractions 
and shortening the labor. 

It is a popular supposition that in feeble, anaemic, 
nervous and delicate persons the anaesthesia is specially 
dangerous, but this is a great mistake; as a rule such 
persons bear it best. Organic disease of the heart and 
lungs constitutes the principal valid objection to the 
employment of these agents, and even when it exists 
I am inclined to question whether the danger is not 
greater without them. Certain it is that anaesthetics 
have been administered to patients suffering from or- 
ganic diseases of those organs, when important surgical 
operations have been necessary, with recovery. 

The author does not for a moment suppose that any 
unprofessional person will ever undertake adminis- 
tration of an anaesthetic. The educated physician alone 
is competent to give it with safety, and he must be 
provided with a pure article and attentively watch 
its progress. The patient must be in the recumbent 
position at the time and the stomach empty or nearly 



MANAGEMENT OF LABOR 161 

so, and the drug is to be inhaled along with plenty of 
atmospheric air. 

Curious and critical persons may inquire why this 
advice is introduced into this work if the directions 
laid down in preceding chapters are of any practical 
value. They may say that any preparation is un- 
necessary when chloroform and ether furnish so reli- 
able and easy an escape from pain. 

In reply, I have only to say that I have not written 
this little work with a view to advocate any particular 
method of procedure or remedy to the exclusion of 
others, but to consider such means as are known to 
myself and the profession by which woman may escape 
the pains and perils of motherhood. That there may 
be other effectual means I do not deny, but if such 
there are I have not learned of them. 

Were I to consider one remedy or plan and not 
others I would greatly diminish the value of this book, 
and in all probability deprive many anxious readers 
of the means of amelioration and relief. There are 
some who can avail themselves of one of the plans 
described and cannot of the others, while in some the 
combination of all the means may be necessary. The 
directions laid down in preceding chapters will in 
a very large per cent of cases render the adminis- 
tration of anaesthetics unnecessary; but in the cases 
in which their employment is demanded it is my desire 
that she know of their value and safety and, by their 
proper use, we shall succeed if all other means should 
fail. 

I do not make any claim to being the first to advo- 
cate anaesthetics in labor or to the discovery that 
these agents can overcome the pains of childbirth. 



162 PAINLESS CHILDBIRTH 

It is nothing new to many; but common as it is it 
is no less a fact that thousands of women suffer with- 
out it and will continue to suffer until they are taught 
to demand relief at the hands of their medical attend- 
ants. 



CHAPTER XIII 



CARE OF MOTHER AFTER DELIVERY 

For a longer or shorter time after delivery the mother 
will continue to require attention, while the care of 
the child has only just begun. The condition of the 
mother will necessarily vary, depending very much on 
the ease with which she has passed the ordeal as well 
as upon her previous physical condition. Her nervous 
system will have received 'a shock of variable inten- 
sity and, if the labor has been an easy one or if she is 
robust and in a good condition to sustain such impres- 
sion, the shock will be mild and of short duration, 
and in proportion to the subsidence will be her return 
to health and comfort. 

The agitation caused by the labor will be succeeded 
by a sense of lassitude and depression, similar to that 
which occurs after any severe exercise. The circulation 
will be affected, the countenance will present a dull 
appearance, and it frequently happens that she will 
be attacked by a chill that may make her teeth chatter. 
Under ordinary circumstances this will soon pass off. 
The circulation will become natural, as manifested by 
a return of the regularity and fullness of the pulse, 
the heat of the surface return, the skin moisten, every 
function become natural and the most perfect, calm 
and delightful slumber follow. 



164 PAINLESS CHILDBIRTH 

During this period a watchfulness is to be observed. 

If the shock is severe and prolonged, the prostration 
extreme, respiration slow and sighing or scarcely 
perceptible, the pulse slow and weak or rapid, small 
and fluttering, interference will be necessary, and small 
quantities of stimulants may be given. Ammonia, 
wine, brandy or whiskey in any palatable form may be 
given in small quantities and often repeated, and grad- 
ually withdrawn as recovery becomes established. 

HEMORRHAGE 

During this time the possibility of hemorrhage must 
not be forgotten, for the symptoms already enumerated 
may be dependent upon loss of blood. Whoever offi- 
ciates in the capacity of nurse must make frequent 
examinations of the napkins to ascertain if the dis- 
charges are too profuse or if they are wholly arrested. 

If the hemorrhage is too free it may be controlled 
by cinnamon tea, five grain doses of gallic acid in 
water, or one half teaspoonful of fluid extract of ergot, 
the doses to be repeated once in from one to four hours 
as may be necessary. Few will require such interfer- 
ence, and particularly if the directions previously given 
have been followed. If, however, these means fail, the 
physician should be notified. 

During this time she must be kept quiet, the room 
slightly darkened and no talking or whispering is to 
be tolerated. She requires rest, sleep and recuperative 
repose to restore her energies; but during sleep she 
is not to be left wholly alone; a competent person 
should remain with her to observe that nothing goes 
wrong. 



CARE OF MOTHER AFTER DELIVERY 165 

LENGTH OF TIME TO REMAIN IN BED 

For the first few days she is to maintain the recum- 
bent position, though she may frequently turn from 
side to side or even sit up in bed; but nearly all authors 
are united in advising that she remain in bed until 
the ninth or tenth day. Women whose muscular tissue 
is more than usually feeble will do well to remain even 
longer before any exertion is made that will require 
muscular effort. 

The reason for such advice is that the uterus which 
has been considerably increased in weight during ges- 
tation may have time to resume its proper size before 
its natural supports will be called upon to retain it 
in its proper position in the pelvis. By following such 
directions the mother will materially diminish the 
liability to uterine displacements. 

I am well aware there are those to whom such advice 
will seem a mockery. Some are compelled to disobey, 
because upon their daily toil depends their supply of 
life's necessities; others again, accustomed to the hard- 
ships of life, will have developed sufficient muscular 
power so that recuperation will not be to them the 
necessity it is to the weaker and more sensitive. In 
a previous chapter, allusion to these circumstances has 
been made. 

INVOLUTION OF THE WOMB 

After delivery, the uterus undergoes a process 
termed involution by which it resumes its previous 
size. On the perfection of this process materially de- 
pends the mother's future health. Having been in- 
creased in weight from sixteen to twenty times or even 
more it may be readily understood what an arrest of 
this process of involution implies. If this process is 



166 PAINLESS CHILDBIRTH 

delayed there will be pain, weight, aching in the back, 
hysteria and perhaps flooding. The hand over the 
abdomen can detect the uterus large and tender. There 
is often inflammation or there may be a lack of muscu- 
lar and nervous power — atony. When this is the case, 
flooding is liable. If the mother continues the use of 
the Mitchella Compound there will be little danger of 
an arrest of involution. 

DIET DURING CONVALESCENCE 

During convalescence the diet of the mother is of 
importance. For the first three or four days a light 
diet, consisting of oatmeal gruel, tea and toast, light 
broth and anything of an unstimulating character is 
to be employed. If, however, the mother is feeble, a 
more nourishing diet will be necessary from the first, 
and beef tea, mutton broth, etc., may be given. After 
the third day the mother may have a nutritious diet, 
milk, oysters, beef tea, mutton broth, rice, eggs, etc., 
etc., gradually returning to her customary diet which 
should be very nutritious. 

THE LOCHIA 

After delivery, a discharge termed the lochia takes 
place from the mother's genitals, varying in its dura- 
tion in different women. In some it may dry up in a 
few days and in others continue for a month or even 
longer. Its too early disappearance may be followed 
by constitutional disturbances, and if not re-established 
will result in an impairment of the general health, 
associated perhaps with some disease of the uterus and 
its appendages. On the other hand, if too long con- 
tinued or too profuse, it will demand attention on 
account of causing debility. 



CARE OF MOTHER AFTER DELIVERY 107 

The lochial discharge is usually greatest in those who 
have previously had children, in women who men- 
struate freely and in those who do not nurse their 
children. 

At first the discharge is composed largely of blood. 
After a while it changes in character and has the 
appearance of a secretion. For a few days it is of a red 
color, but rather thinner and more watery than blood 
and does not clot; then it becomes yellowish, perhaps 
greenish, watery, with often the appearance of puri- 
form matter and finally of a soiled water appearance. 
It is accompanied with a peculiar odor. 

CLEANLINESS ABSOLUTELY NECESSARY 

This is quite an appropriate place to speak about 
the need of cleanliness. The value of antiseptics and 
surgical cleanliness in the treatment of confinement 
cases is proved every day by the perfect results and 
uninterrupted recoveries that come when attention is 
paid to these subjects. 

Everything around or near the newly-made mother 
should be kept spotlessly clean. The clothing and bed 
linen should be changed at least once a day. Every 
four hours, or oftener if necessary, for the first three 
days the genitals should be washed clean with soap 
and water and an antiseptic solution (one dram of 
lysol to one quart of clean lukewarm water) allowed 
to flow over them from a fountain syringe held about 
two feet above the mother's hips. A bed-pan under 
the hips will protect the bed. The parts should be 
thoroughly dried with a clean, sterile towel and a fresh 
napkin put on. If strict cleanliness is observed there 
will be no odor to the discharges. Vaginal douches are 
not at all necessary in a normal case. But if for any 



168 PAINLESS CHILDBIRTH 

reason the discharge acquire a bad or fetid odor an 
antiseptic vaginal douche (one dram of lysol in one 
quart of water) should be given at once with a foun- 
tain syringe and repeated two or three times a day 
until the discharge becomes normal. Douching should 
always be done gently, so as not to injure the lining 
membrane of the vagina. 

If the lochia becomes too profuse and exhausting 
it must be modified; a teaspoonful of wine of ergot 
may be given twice a day to improve the contractile 
power of the uterus, and some of the elixirs of cinchona 
and iron may be given two or three times a day for 
their tonic influence. These elixirs can be found in 
every well-regulated drug store or may be substituted 
by one or two grains each of quinine and carbonate 
of iron at a dose. 

AFTER-PAINS 

Usually within an hour after delivery, uterine con- 
tractions will occur which resemble more or less closely 
the throes of labor and are termed after-pains. As a 
rule, following the first delivery they are so slight as 
to occasion little or no annoyance, but become more 
and more severe with each succeeding child. Most 
writers regard them as salutary, being necessary to 
expel the clots that have formed within the uterine 
cavity, and thus prevent hemorrhage and to enable 
the organ to diminish its size. 

Prof. Bedford says: 

These pains are what are known as after-pains. They are 
nothing more than the contraction of the uterus ridding itself 
of the fluids contained within it, and at the same time through 
these contractions gradually returning, as far as may be, to its 
pristine state. After-pains, therefore, instead of being regarded 



CARE OF MOTHER AFTER DELIVERY 169 

as morbid or pathological, are to be classed among the usual and 
necessary phenomena of childbirth. In a woman with her first 
child — a primipara — these pains are ordinarily slight ; in a multi- 
para, on the contrary, they are oftentimes severe and harrassing. 
The reason of the difference is that in the former case the uterus 
is invested with vigor and tonicity and consequently soon 
becomes restored to its original condition; while, in the latter its 
walls are flaccid and the contractions, therefore, more protracted. 

Prof. Bedford's words reflect to a great degree the 
opinions of the medical profession in this respect and 
furnish us with a practical suggestion, viz.: The more 
nearly perfect the integrity of the uterus and its asso- 
ciate tissues the less pain there will be after labor. 

This suggestion brings us back to a subject already 
partially considered in a previous chapter in which 
directions are given for the removal of abnormal 
uterine conditions and restoration of the muscular 
tissues to a healthy and vigorous state, by the employ- 
ment of the squaw vine, blue and black cohosh, all of 
which in just the right proportions are contained in 
Dr. Dye's Mitchella Compound. True, our observa- 
tions then were made with a view to relieve the pains 
of labor, but they hold equally good with reference 
to the relief or prevention of after-pains. I can assure 
the reader that this is not an unfounded hypothesis, 
but an established fact often demonstrated. 

There are those, however, who have not had the 
advantage of previous preparation and, for the relief 
of such, it is highly proper to consider the remedial 
resources at our command. When these pains are 
protracted by a lax and enfeebled condition of the 
uterus a small dose of ergot will often promote the 
contraction and thus diminish their repetition. The 
remedial influence of the black cohosh or cimicifuga is 



170 PAINLESS CHILDBIRTH 

similar and may be continued while the after-pains 
last, in doses of five drops of the fluid extract or homeo- 
pathic tincture in water, repeated every three or four 
hours. 

When these remedies are unavailing and the suffering 
great, it may become necessary to resort to others to 
diminish sensibility to pain. Ten grains of bromide 
of potash or five grains of phenacetin every four hours 
for two or three doses, or a warm drink or a soapsuds 
enema will often give relief. Should, however, the 
pains become so severe as to prevent sleep or cause 
exhaustion an opiate should be given by the physician. 

THE BLADDER 

It not unfrequently happens after a somewhat se- 
vere or tedious labor that the woman will lose control 
of the bladder and either be unable to discharge the 
urine at all or perhaps it will constantly dribble away 
from her as fast as it is formed. In other cases she 
may have power to pass or retain it, but its passage 
will be painful and the urethra remain sensitive and 
tender. 

When she is unable to discharge the urine and the 
bladder is distended and painful, the catheter should 
be resorted to, and it is a very easy matter to draw 
off the urine if the operator knows how. As no one but 
a physician would be likely to attempt to pass a catheter 
no necessity exists here for describing the operation. 
The woman should make an attempt to pass water 
in the course of six or eight hours after delivery. The 
first attempt will quite likely be somewhat painful, 
and if the urine is hot and burning it may be well to 
resort to anodyne diuretics, and a teaspoonful of sweet 



CARE OF MOTHER AFTER DELIVERY 171 

spirit of nitre may be given in a cup of flaxseed tea. 
If this does not afford relief it may be repeated and two 
drops of tincture of belladonna added to the next dose. 

Should the woman be unable to pass her urine in 
from ten to twelve hours, and there is any evidence 
that there is any urine in the bladder, before making 
use of the catheter the following expedients may be 
tried : Place a bed-pan half full of warm water under 
the hips and apply hot wet cloths, or a warm flaxseed 
poultice to the lower abdomen; the warmth and moist- 
ure will often relax the tissues and the discharge take 
place. 

The influence of the mind upon matter is often 
illustrated in cases of the kind, as stated by Prof. 
Bedford in his Principles and Practice of Obstetrics. 
He says : 

I somewhere read years ago of the practice in these cases of 
pouring within the hearing of the patient water from a vessel 
slowly into a pitcher; and I can vouch for its efficacy in several 
cases in which I had recourse to it. * * * * * 

It is a curious but interesting circumstance that occasionally 
after the patient has made vain attempts to relieve herself and 
the failure of the ordinary remedies, the moment the accoucher 
suggests the necessity of having recourse to an instrument for 
the purpose of drawing off the water, madam, alarmed at the 
idea of an instrument, tells the nurse in an undertone, 'Oh, I 
think I can relieve myself now. ' The nurse brings the bed-pan, 
and sure enough the bladder is evacuated. Some persons can- 
not evacuate either bladder or bowels upon a bed-pan, but 
seated upon an ordinary chamber vessel they find it easy enough, 
and particularly if it is half filled with hot water. 

THE BOWELS 

The common practice is to open the bowels on the 
second or third day. A wineglassful of fluid magnesia 



172 PAINLESS CHILDBIRTH 

is an excellent laxative for this purpose, but, if pre- 
ferred, two to four teaspoonfuls of castor oil or one 
teaspoonful of compound licorice powder or a copious 
rectal injection of soap and water (to which a few 
teaspoonfuls of glycerine or castor oil is added) may be 
given. After the third day the bowels should move 
daily. If constipated, give ten or fifteen drops of the 
fluid extract of cascara sagrada in water thrice daily 
until a regular daily action is brought about. 

GAS IN THE BOWELS— TYMPANY 

An accumulation of gas in the bowels will give rise 
to distention and suffering, sometimes amounting to 
severe distress. Pressure will cause pain which may be 
mistaken for inflammation. In distention, the swollen 
abdomen will sound like a drum if gently tapped upon, 
and pressure though at first painful, will, if gentle and 
continued, soon give relief, while if inflammation is 
present the longer the pressure is continued the more 
painful it will become. 

In this trouble, few if any remedies can equal tur- 
pentine. Add one half to one teaspoonful of "spirits" 
of turpentine to an ordinary dose of castor oil and take 
at a dose. If the taste is offensive it may be given in 
capsules or syrup of gum arabic. The application of 
a warm flannel sprinkled with turpentine to the abdo- 
men is also beneficial. A soapsuds enema or one half 
ounce of the milk of asafcetida injected into the rectum 
often causes the gas to be expelled and so gives relief. 
An excellent homeopathic remedy is bryonia, of which 
five drops of the tincture is to be dissolved in one half 
glass of water and a teaspoonful given every hour. 
The abdominal binder often adds to the distress and 
should be removed. 



CARE OF MOTHER AFTER DELIVERY 



173 



If there be fever along with the distention and 
pain, the trouble may be due to inflammation (peri- 
tonitis), and the physician should therefore be notified 
at once. 

THE BREASTS AND NIPPLES 

If the mother has followed out our instructions as 
to the proper care of the breasts and nipples during 
pregnancy the chances of her having trouble with them 
will be very small. But if she has not given the subject 
any attention, in a few days after the child begins to 
nurse they will become exquisitely sensitive and painful. 
An application of the child will be an absolute punish- 
ment, and nursing will be a severe struggle between 
duty and physical suffering. The nipples are liable to 
become excoriated or cracked and, being constantly 
in use, are difficult to cure, for every time the child 
nurses it opens the fissures anew. When the pain be- 
comes so great that the mother can not tolerate the 
efforts of the child she becomes liable to another afflic- 
tion. The breasts become engorged, inflammation en- 
sues, an abscess forms and she has a " broken breast." 





Figure 16 



Figure 11 



174 PAINLESS CHILDBIRTH 

From the day that nursing begins, the nipples should 
be gently but thoroughly bathed before and after each 
feeding with a small pad of absorbent cotton soaked 
with a saturated solution of boracic acid. The breast 
binder loosely applied prevents sagging of the breasts 
and often gives comfort and relief. If cracks or fissures 
appear in but one nipple the child should nurse from 
the other breast for several feedings, and if the sore- 
nipple breast becomes overfilled the milk should be 
drawn from it with a breast pump. (Fig. 16.) When the 
crack or fissure is small and not very painful a nipple 
shield (Fig. 17) will give relief and in no way interfere 
with the use of salves or other remedies. The nipple 
shield and breast pump should be kept scrupulously 
clean. Cracks and fissures of the nipple usually heal 
after a few applications of either one of the following 
ointments: 

(1) Castor Oil, . . . 2 drams 
Sub nitrate of Bismuth, . . 2 drams 
Boracic Acid, . . . .10 grains 

Directions — Spread a little of the ointment on a piece of soft, 
clean linen and apply to the nipple. 

(2) Compound Tincture of Benzoin, 15 drops 
Vaseline, K ounce 
Lanolin, ... 3^ ounce 

Directions — Same as preceding. 

If the crack or fissure becomes deep it should be 
cauterized by the physician. 

INFLAMMATION OF BREAST— ABSCESS 

A painful, swollen, caked breast is almost invariably 
the result of poisoning or infection from a cracked or 
fissured nipple, but may be due to violent rubbing or 
rough use of the breast pump. The affected part of 



CARE OF MOTHER AFTER DELIVERY 175 

the breast becomes painful, hot, tender, swollen and 
red. Fever, chills, headache, constipation, exhaustion 
and other symptoms show that the woman is really 
ill. Should the condition last for more than three days 
an abscess is to be feared. From the moment that 
symptoms of inflammation appear, the child should not 
be allowed to nurse from that breast. Put on a breast 
binder and apply an ice bag or warm poultices. Open 
the bowels freely with a dose or two of Epsom salts 
and take very little liquid, either as drink or food. 
The breast pump should not be used nor the breast 
massaged. The following ointment if used before an 
abscess forms often gives relief: 

Powdered Poke Root, . . 1 dram 

Camphor, .... 8 grains 

Vaseline, .... 1 ounce 

Directions — Spread on soft linen and apply to breast. 
If an abscess forms it should be opened at once by 
the physician. 

SORE MOUTH OF NURSING MOTHERS 

During nursing and sometimes during the latter 
months of pregnancy the mother may be afflicted by 
a peculiar species of sore mouth, which may be so 
severe as to cause great suffering and seriously inter- 
fere with the taking of food. This condition is supposed 
to depend upon some peculiar unhealthy state of the 
blood, and is oftenest found in those who are suffering 
from an impaired condition of the general health, 
among the scrofulous, etc. 

The treatment consists in improving the general 
health. Cinchona, iron and quinine may be taken 
with a nourishing diet, and the mouth washed with 
borax and glycerine in water, chlorate of potash or an 



176 PAINLESS CHILDBIRTH 

infusion of the common gold thread or golden seal. 
Let them all be of a strength that can be used without 
causing much pain. I have found the baptisia an ex- 
cellent remedy. I have usually given it in doses of 
fifteen drops of the tincture three or four times a day. 
The remedy can usually be obtained at first-class drug 
stores. It is also called wild indigo, horse-fly weed, 
etc. The homeopathic remedies most likely to suit 
are arsenicum, mercurius, nitric acid, etc. 

LACK OR FAILURE OF THE BREAST MILK 

Breast milk is the natural food of the baby and when 
it is not secreted in sufficient quantity or of the right 
quality the infant begins to lose in weight, becomes 
sleepless, fretful, irritable, colicky and cries most of the 
time. Every effort should be made to improve the 
milk. The mother should take a good extract of malt, 
an abundance of milk, water, chocolate, cereals, gruels 
and soups. Twice a day the breasts should be bathed 
in cool water and afterwards thoroughly massaged. 
Dr. Dye's Mitchella Compound Tabules should be 
taken according to directions amd pale, anaemic women 
need a good iron tonic and abundance of fresh air. 

TO DRY THE BREASTS 

When for any reason it is considered advisable to 
dry up the milk the following plan should be adopted : 
Empty the breasts by a breast pump and apply a 
snugly fitting breast binder. Abstain from water and 
liquid foods as much as possible and keep the bowels free 
and open with a daily dose of Epsom or Rochelle salts. 

CHILD-BED FEVER— LYING-IN-FEVER— PUERPERAL 
SEPTICAEMIA— PUERPERAL INFECTION- 
PUERPERAL SEPSIS 

All these terms refer to the same condition — a 
poisoning of the birth tract that assumes many different 



CARE OF MOTHER AFTER DELIVERY 177 

forms varying both in extent and severity. It is a 
preventable disease and every nurse attending a case 
of confinement should see that everything around or 
near the patient is kept spotlessly and surgically clean 
as advised in another paragraph. 

THE SYMPTOMS 

These will vary according to the part affected and 
the intensity of the disease. The usual symptoms are 
fever, chill, headache, fast pulse, weakness, consti- 
pation or diarrhoea; the vaginal discharges acquire a 
foul odor or stop altogether. Over or near the womb 
there is tenderness or pain. When peritonitis super- 
venes the symptoms are more severe. 

TREATMENT 

Any symptoms of fever in a woman recently con- 
fined should at once be reported to the physician. 
It is of course possible that the fever is due to other 
causes, but the greatest danger is poison or infection. 
The sick-room should be quiet and well ventilated. 
Frequent spongings of the body with cool water will 
prove refreshing and help to reduce the fever. The 
bowels should be kept open by a dose or two of Epsom 
salts, and if tenderness exists near or over the womb 
turpentine stupes or hot poultices are applied. Abun- 
dance of liquid or semi-solid, easily digested food should 
be given in small quantity frequently repeated. Alco- 
holic stimulants, saline rectal injections, Crede's oint- 
ment and serums will likely be ordered by the physi- 
cian who will also open any abscess that may form 
during the progress of the disease. 



CHAPTER XIV 



THE INFANT AND ITS CARE 
THE WEIGHT 

The average weight at birth is about seven pounds, 
and male children are usually heavier than females. 
During the first three days, or until it begins to nurse, 
the baby loses four or five ounces in weight, but this 
is regained by the end of a week. At least once a week 
the baby should be stripped of all clothing and accu- 
rately weighed. An ordinary grocer's scales with a 
scoop (Fig. 18) will answer splendidly for this purpose. 




Figure 18 



THE INFANT AND ITS CARE 179 

It is advisable to keep a record of the weight each week, 
because a steady gain is usually strong evidence that 
the baby is healthy and thriving. For the first six 
months there should be a weekly gain of four to eight 
ounces, and at the end of the fifth month the baby 
should weigh twice as much as it did at birth; at the 
end of the first year, three times as much as at birth. 

THE LENGTH 

The average length of an infant at birth is 19% 
inches — boys a little longer than girls. During the first 
year the baby grows a little over eight inches. 

THE HEAD 

The head of a male child at birth is on the average 
about half an inch greater in circumference than that 
of a girl and the bones of the skull are generally harder. 
In women who do not follow the advice given in pre- 
ceding pages about diet and the use of Dr. Dye's 
Mitchella Compound these two conditions account for 
the greater protraction of labor, the frequent necessity 
for the use of instruments and the greater danger to 
both mother and child at the birth of a boy baby. 

The circumference of the head at birth is 133^ to 
143^2 inches — nearly half an inch larger than the chest. 
The head, often misshapen, deformed or elongated as 
a result of pressure during birth, usually assumes its 
normal shape by the end of the first month. The two 
soft triangular spaces are known as the fontanelles. 
The posterior fontanelle is closed and solid before the 
and of the second month; the anterior, not until the 
baby is from fourteen to eighteen months old. 

SIGHT 

For the first few weeks of life the eyes are very sensi- 
tive and should at all times be protected from strong 



180 PAINLESS CHILDBIRTH 

light. The sleeping room should be slightly darkened 
and when out for an airing the sunshade or top of the 
baby carriage or perambulator should be properly ad- 
justed to shade the eyes. When it is about one month 
old the baby's eyes will follow a light in the room. 
For several weeks the infant is unable to focus both 
eyes on an object — this at times causes irregular move- 
ments of the eyes that are sometimes mistaken for 
strabismus (cross-eye). In the sixth month the baby 
is able to positively distinguish its father and mother 
from others. 

HEARING 

For the first day or two the baby is deaf. The ability 
to hear comes about the fourth day and the hearing 
steadily improves so that by the fifth or sixth week 
the baby is disturbed by loud talking or unusual noises, 
and before the end of the third month will turn its 
head in the direction from which the sound comes. 

HOLDING UP THE HEAD 

By the fourth month the baby as a rule is able to 
hold its head upright without assistance. 

CRAWLING— SITTING— STANDING— WALKING 

In the fifth month the baby is able to crawl on all 
fours; in the seventh month to sit up alone; in the 
ninth or tenth month the first attempts are made to 
stand alone, and in the twelfth or thirteenth to walk. 
The baby should not be allowed to walk unsupported 
too early in life. 

SPEECH 

Girls begin to talk earlier in life than boys. When it 
is about one year old the average child is able to say 
"papa" and "mamma", and by the end of the second 



THE INFANT AND ITS CARE 181 

year begins to form sentences of two or three simple 
words. 

BATHING THE BABY 

A daily full tub bath should not be given until the 
cord has dried and fallen off and the navel thoroughly 
healed. The best time for the bath is in the morning, 
about one hour after the baby has been nursed or fed. 
The room should be warm and free from drafts, and 
before the bath is started everything likely to be needed 
is so placed as to be within easy reach. The tub should 
contain just enough water to cover the baby's body. 
For the first week or ten days the temperature of the 
water as ascertained by the bath thermometer (Fig. 13) 
should be 99° to 100° F. ; this should be gradually 
reduced so that at the end of the first month it is 95° F., 
and after the sixth month 90° F. First wet the baby's 
head and then gently lower or immerse its body into 
the water — the head and back being well supported, 
by the nurse's left hand, the body washed with her 
right. After the bath, which should not last longer 
than four or five minutes the baby is taken out, wrapped 
in a soft warm towel on the nurse's knee and its body 
thoroughly dried by gently rubbing or patting the 
towel. The groins, armpits and buttocks should be well 
powdered with corn starch or a good talcum powder, 
but when the skin is chafed or sore, stearate of zinc 
powder or oxide of zinc salve is to be preferred. Do 
not use a sponge in bathing the baby — a wash cloth 
of soft muslin or cheesecloth is much easier to keep 
clean and on that account is preferable. 

SLEEP 

In infancy there is a necessity for considerable sleep, 
and when the sleep is calm and natural it should be 



182 PAINLESS CHILDBIRTH 

continued without interruption for considerable time. 
A young child will be apt to sleep between each feed- 
ing, and it is a question of importance to decide whether 
the child should be waked up to nurse. I would advise 
that it be done, so that there may be as great regularity 
about sleeping and eating as possible, and if this plan 
is carried out the trouble will be materially reduced. 
Usually for the first month or two the child will pass 
two thirds to three fourths of the twenty-four hours in 
sleep. From the second to the sixth month it will 
naturally sleep twelve hours at night, waking two or 
three times to nurse, and taking two or three naps 
during the day. 

It should not be expected to sleep too much, for as 
it becomes old enough to notice objects it will amuse 
itself with playthings and not sleep so much. Until 
a child is two years old it will require a nap in the fore- 
noon and one in the afternoon. As it grows older it 
will sleep less. By a wise provision of nature the amount 
of sleep in health will usually regulate itself, though 
the mother may take advantage of it and divide the 
sleep during the day into regular intervals for her own 
convenience and the welfare of the child. 

Do not bury it beneath a mass of heavy bedclothes 
nor cover it so lightly that it will be chilled. Maintain 
as nearly as possible an even temperature. The room 
should be moderately darkened while sleeping. There 
should be plenty of pure air, but care is to be taken 
that it is not left to sleep where a current of air may 
blow upon it. Do not cover its face with the bedclothes. 
Give it plenty of room. A crib is better than to have 
it sleep in the bed with the mother. Its bedding should 



THE INFANT AND ITS CARE 183 

be freely and frequently aired and kept free from all 
unhealthy odors. 

THE ABDOMINAL BAND OR BINDER 

For four or five months the baby should wear an 
abdominal binder or belly band, made of soft white 
flannel six or eight inches wide and long enough to 
encircle its body two or three times. When the flannel 
binder is discarded a knitted band with shoulder straps 
should be substituted. The object of the binder is at 
first to hold the dressings of the cord in place; later 
on, by supporting the abdomen, it helps to prevent 
rupture when the baby cries or strains. To hold it in 
place tying with strings or tapes attached to one end 
of the binder will be found better than pinning or sew- 
ing. The binder should be put on evenly and smoothly, 
but not too tightly, as that would do harm by prevent- 
ing the movement of gas or wind in the bowel. 

THE EYES 

Because they are so sensitive every precaution should 
be taken to prevent the oil, soap or water used in 
sponging or bathing from getting into the baby's eyes. 
Cleanliness of the eyes is necessary at all times and, 
every morning at the time of bathing, the outside of 
the eyes should be washed with a small pad of absorb- 
ent cotton soaked in a solution of boracic acid. 

INFLAMMATION OF THE EYES— OPHTHALMIA 
NEONATORUM 

Three or four days after birth, infants are often 
attacked by a peculiar species of inflammation of the 
eyes which should receive immediate attention, for 
delay here is especially dangerous and may result in 
destruction of sight, while if promptly and properly 
treated it will generally yield with little trouble. When 



184 PAINLESS CHILDBIRTH 

due to cold, exposure to bright light or soap getting 
into the eyes it is not nearly so dangerous as when 
caused by infectious discharges of the mother getting 
into them during birth. In the severe cases the eyes 
become red, the eyelids swollen and even closed, and 
there is a profuse discharge of pus. A physician should 
be called at once — not a moment wasted. Until his 
arrival, cold compresses should be applied to the eyes 
every few minutes and the secretion frequently washed 
away with a pad of absorbent cotton wet with saturated 
solution of boracic acid. If for any reason the physi- 
cian's visit is delayed the following should be used: 

20% Solution Argysol, . . 1 ounce 
Directions — Wipe away all secretion ; separate the lids and in- 
stil a few drops in the eye with a medicine dropper. 

THE BOWELS 

Among the first things likely to demand attention 
is the evacuation of the child's bowels. Usually the 
secretion in the mother's breasts will be sufficient, and 
we may wait for twenty-four hours without interfering. 
If at the expiration of this time the bowels have not 
moved, give a tablespoonful of a moderately strong 
tea of elder flowers sweetened with molasses. Repeat 
every two or three hours until the object is accom- 
plished. A small dose of castor oil is often given, with 
good results. The best way to give the castor oil is 
to drop it into the baby's mouth from a medicine 
dropper (Fig. 15). 

THE BLADDER AND KIDNEYS 

Usually the kidneys perform their functions naturally 
at birth, and if the child does not pass its water within 
ten or twelve hours there will be more apt to be some 



THE INFANT AND ITS CARE 185 

obstruction to the flow than a lack of secretion. Ob- 
serve carefully that it has not urinated. If the urine 
is retained and the bladder full it may be felt as a 
round, circumscribed tumor in the lower part of the 
abdomen. If such be the case a physician is to be 
called at once, who will introduce a catheter or bougie 
for the child's relief, unless some other expedient he 
may suggest avails. If there is no urine secreted, then 
a few drops of sweet spirits of nitre in water may be 
given. Before resorting to medicine, a correct diagnosis 
should be made, for if the bladder is full and nitre is 
given it may increase the trouble. 

THE DIAPERS 

The napkin or diaper should be made of soft, thick 
absorbent material and when put on the infant should 
be warm and dry — a wet diaper causes the skin to 
become red and sore. Soiled napkins should be placed 
in a covered receptacle and as soon as possible boiled 
in plain water, washed thoroughly clean and afterwards 
rinsed free of all soap, alkali or washing powder — 
such things are irritating to the delicate baby skin 
and often cause chafing or even eczema of the buttocks. 
A diaper wet with urine should not be used again until 
it has been washed and dried. 

SOME GOOD ADVICE 

Almost simultaneously with birth does feeding and 
physicing begin. So extensive is the practice that a 
baby may consider itself extremely fortunate if it 
escapes a whole hour after it is born without having to 
take something, and from that time forward there is 
always a teaspoonful of some food or drug waiting for 
it. If ever it ventures to test its lungs or voice it must 
be considered either sick or starving, and down goes 



186 PAINLESS CHILDBIRTH 

the favorite "dope." Indeed, they sometimes live in 
the world a whole day without getting their little mouths 
empty enough to enter an objection to the way business 
is done, by a cry. Ludicrous as such remarks seem, 
they are nevertheless too near the truth, for, from the 
baby's arrival it is expected to freely partake of "pap, " 
"sling," castor oil, paregoric, soothing syrup, etc., etc., 
or else it must eat every time it wakes up, if indeed it 
is not awakened to feed it. 

I sincerely hope that those who read these pages 
will remember that the baby is not always sick nor 
hungry when it cries a little. More babies die from over 
than under feeding. Nothing can be farther from my 
wish than to neglect these little strangers, but when 
we realize the growing tendency to keep them half 
stupid with opiates in the form of powder, paregoric, 
soothing syrup, baby syrup and the like, we are sure our 
language is not half strong enough. There are times 
when opiates are needed, but to stultify a child's intel- 
lect and depreciate its vitality by narcotizing is an 
abomination. 

VOMITING 

Vomiting must not always be regarded as an evi- 
dence of disease, for many healthy children vomit. 
Indeed, it must be regarded as a wise provision of 
nature for the disposal of an excess of food. When 
this is the case, care should be exercised to diminish 
the quantity of food taken. Vomiting may, however, 
be caused by an unhealthy condition of the milk; it 
is also the result of irritation of the stomach, and when 
due to this latter cause the child soon becomes pale, 
feeble, distressed looking and loses its appetite. 



THE INFANT AND ITS CARE 187 

The remedies mostly to be depended upon in these 
conditions are to be derived from the homeopathic 
school, and are aconite, arsenicum, ipecac, nux vomica 
and Pulsatilla. A drop of the tincture of either may be 
put into a glass half full of water, of which a teaspoonful 
is to be given every three or four hours. Preparations 
of pepsin are much employed for the purpose, and for 
an infant of a few months one grain of pepsin and one 
fourth grain of subnitrate of bismuth may be given 
every three or four hours with advantage, thus: 

Pepsin, . . . .. . 4 grains 

Subnitrate of Bismuth, . . 1 grain 

Make four doses. One every three hours. 

Should the vomited matter contain blood or bile, 
the physician should be notified. 

Vomiting very soon after feeding is often a sign that 
the baby gets the milk too fast on account of the hole 
in the rubber nipple being too large. The same symp- 
tom may result from tight bands or rough handling 
after feeding. With a suitable nipple, loose clothing 
and rest after taking food the vomiting will not occur. 

In bottle-fed babies who throw up or spit up sour 
milk many times a day the trouble is usually overcome 
by lessening the amount of cream in the food. 
INDIGESTION 

This is a very frequent disturbance in infancy, and 
is usually due to improper feeding — irregular, too much 
or too fast. In bottle-fed babies unsuitable food is 
usually the cause. 

Vomiting after feeding is as a rule the first symp- 
tom, but if the stomach trouble persists, the baby 
becomes restless and feverish, cries after being fed or 
nursed, and suffers from colic, rumbling of gas in the 



188 PAINLESS CHILDBIRTH 

bowels, and diarrhoea. The stools are often green, 
foamy or curdy, and frequently so acrid that they cause 
the skin around the anus to become red and sore. 

When symptoms of indigestion appear, the baby 
should not be nursed or fed for twelve to twenty-four 
hours. Give the baby a dose of castor oil to clean out 
the stomach and bowel. Barley, rice or albumen water 
may be given every three or four hours. When nursing 
is resumed, the feeding should for a few times be shorter 
than usual, and one half a teaspoonful of lime water 
in the same amount of water may be given to the child 
before it is put to the breast. Caking of the mother's 
breast should be prevented by using the breast pump 
regularly every three hours. All symptoms of indiges- 
tion usually quickly disappear after the feeding is 
properly regulated. 

COLIC 

This is a very common ailment in both breast and 
bottle-fed babies. It is caused by painful contractions 
of a part of the bowel muscles, and always indicates 
some disturbance in the intestine resulting from irregu- 
lar or improper feeding. The symptoms of colic are 
sharp cries, drawing up of the feet, hard and rigid 
abdomen and sometimes rumbling of gas in the bowels. 
When the gas is expelled by the rectum the pain ceases, 
the child is quiet and usually falls asleep. At times there 
is diarrhoea with green or curdy stools. 

TREATMENT 

In a baby suffering from an attack of colic, care 
should be taken that the abdomen and feet are well 
warmed by dry, hot flannels or a hot water bag. An 
injection into the bowel of four ounces of lukewarm 
water to which half a teaspoonful of glycerine is added 



THE INFANT AND ITS CARE 189 

usually expels the gas and gives relief. A drink of a 
few teaspoonfuls of hot water containing a few drops 
of essence of peppermint is often very helpful. When 
due to flatulence, a little camphor sling, tea of fennel 
seed, sweet flag, celery, chamomile, etc., may be used. 
I have, however, found colocynth one of the grand 
remedies for infantile colic. It may be given as prepared 
and found in the homeopathic medicine cases, or thus: 

Tincture of Colocynth, . . 2 drops 

Water, . . . . . 2 ounces 

Dose — A teaspoonful every hour. 

One dose will usually suffice, and by repeating it 
once in four or five hours the tendency to colic is often 
broken up. 

Paregoric and whiskey should never be given to 
colicky babies. 

Between the attacks the feeding should be regulated 
and treatment given for the indigestion upon which 
the colic depends. 

THRUSH 

This is a disease of the mouth and is also known as 
aphthae or canker. It is most common among pale, 
delicate or unhealthy children, and those brought up 
by hand (bottle-fed babies), or those whose hygienic 
surroundings are defective. It is largely due to faulty 
nutrition, indigestion, improper food or lack of cleanli- 
ness of the mouth, feeding bottle or rubber nipple. 

The symptoms consist in the appearance of small 
white specks or patches in the corners and lining of 
the mouth and upon the tongue, resembling bits of 
curdled milk, which are disposed to spread and multi- 
ply, extending down the throat to the stomach and in 
some cases the whole length of the intestinal tract. 



190 PAINLESS CHILDBIRTH. 

The mouth becomes hot and painful, the lips swollen, 
the saliva dribbling away. The child is feverish and 
restless, grasps the breast in its mouth and immediately 
lets go again on account of the pain it causes, is fretful, 
cries with pain and gives other signs of suffering. The 
pulse is quick and feeble, vomiting and colic may occur 
or a diarrhoea develop that will cause more or less 
emaciation or wasting. 

Treatment. — In the outset we must endeavor to 
prevent the extension of the disease, give attention to 
the surroundings, endeavor to obtain pure air and water 
or if convenient a change of climate. If nursing, see 
that the nipple is washed before and after nursing with 
boracic acid solution and that the mother's milk is 
wholesome; if not, seek to improve her condition or 
else wean the child, secure a wet nurse or adopt artifi- 
cial feeding. If brought up on cow's milk, see that the 
milk is sweet and good and obtained from a healthy 
herd. The nursing bottles and rubber nipples should 
be kept scrupulously clean as advised on page 207. 

In older children a change of food often accomplishes 
great results. Avoid acids, sweets and fats. A little 
beef tea, mutton or chicken broth, soft boiled rice, 
oatmeal gruel, pasteurized milk, etc., varied a little 
are better in these cases than persistent feeding with 
milk. 

When the mouth is dry and the child feverish and 
thirsty, do not forget to give it a little cold water; it 
is as grateful in small quantities to the child as to an 
adult. 

To overcome the acidity and regulate the bowels 
give small doses of the neutralizing mixture (page 412) 
and if the diarrhoea is exhausting, add three to five 



THE INFANT AND ITS CARE 191 

drops of the fluid extract of cranesbill to each dose. 
Alternate with : 

Fowler's Solution, ... 5 drops 
Fluid Extract Baptisia, . . 15 drops 

Water, ..... 4 ounces 
Dose — A teaspoonful every four hours, two hours from the 

doses of the neutralizing mixture when the symptoms require 

the use of that also. 

If indigestion predominates, give a grain or two of 
pepsin and one half a grain of subnitrate of bismuth 
after or immediately before each feeding. 

For local application in the mouth, many old fash- 
ioned remedies have had a time-honored reputation, 
as an infusion of goldthread, sage and honey, borax 
and honey, alum and honey, etc. One part of peroxide 
of hydrogen in eight parts of water is an excellent 
mouth wash. 

The following answers a good purpose, and if in 
using it a little is swallowed it is beneficial rather than 
otherwise: - 

Boracic Acid, . . . .20 grains 

Fluid Hydrastis, }/% dram 

Glycerine, .... 1 dram 

Water, ..... 2 ounces 
Apply with a soft brush, touching the sores several times a 

day, or put one fourth to one half a teaspoonful into the mouth 

three or four times a day. 

A change to the following, after using one vial of 
the above, is often advisable: 

Borax, . . . . .24 grains 

Honey, ..... 3 drams 
Distilled Water, ... 3 ounces 

Directions — Apply on a swab or use as mouth wash every 
four hours. 



192 PAINLESS CHILDBIRTH 

The disease is often met with in older children or 
adults. Then the same remedies increased in dose or 
strength will be equally appropriate. 

JAUNDICE 

In many infants a yellowish discoloration of the skin 
appears in the first week of life. Usually it is a very 
mild affection and rarely lasts longer than a week. 
Occasionally, however, it assumes a more severe type, 
the skin and whites of the eyes become yellow; the 
stools, clay-colored; the child drowsy, with griping 
pains; the urine scanty and staining the diapers yellow. 

No medicines are needed in the average case, but if 
regulation of the feeding, and flushing of the lower 
bowel with a soapsuds or saline enema do not cause 
an early disappearance of the jaundice, a physician 
should be called to prescribe for the baby. 

ROCKING THE BABY 

There is another reprehensible custom which, though 
perhaps not exactly a moral consideration, is not 
wholly inappropriate here, and that is rocking or 
jolting the child every time it frets. Children can be 
taught to go to sleep just as well without rocking as 
with, and were I to bring up a score of children none 
of them should be rocked. True, it often quiets them 
and induces sleep, but it does so by causing an abnormal 
condition of the brain and nervous system. Let grown 
persons try cradle rocking or swinging and see how they 
will like it. If motion is to be employed, a carriage is 
far preferable. 

Frequently, when the child is crying from colic 
and its little abdomen is distended with wind, or when 
there may be determination of blood to the head, the 
head hot, feverish and, if the child could speak, it 



THE INFANT AND ITS CARE 193 

would add, painful, it is taken upon the knee and 
jolted, jounced and trotted, and the harder it cries the 
more vigorous the process until it falls into an uneasy 
sleep. I always feel as if I want to horsewhip a mother 
or nurse who treats the suffering child in that way. 
Were they to try the same process when suffering 
similarly to the child they would ransack the vocabu- 
lary for words expressive of condemnation. Often 
when attending children suffering with disease of the 
brain I have more trouble to protect them from swing- 
ing and jolting than anything else — motions that are 
not only excruciatingly painful, but absolutely injurious. 

THE WET NURSE 

In the selection of a wet nurse, obtain one as near as 
possible the age of the mother and whose child is not 
much older than the child she is also to nourish. It 
is needless to say she must be free from disease and her 
breasts and nipples well developed. A wet nurse should 
have the same class of food and exercise as that to 
which she was accustomed. Even when the mother 
herself undertakes to nurse the child, if she becomes 
extremely emaciated or attacked by any disease it is 
best that she transfer her charge to the breast of a 
hired nurse. 

BABY NEEDS WATER TO DRINK 

Give the baby a drink of water, often. Many mothers 
never think of this, and the little things suffer intoler- 
ably from thirst which milk does not quench. This 
causes babies to nurse when they do not need it. Offer 
it to the child frequently whether it nurses or not. 
Don't be afraid of water and don't adulterate it. Pure, 
clear cold water is as grateful to an infant as an adult, 
and will contribute to its health and good nature. 



194 PAINLESS CHILDBIRTH 

FRESH AIR AND SUNSHINE 

These are just as necessary for a baby as for an adult. 
In the warm, clear days of summer a baby may be 
taken outdoors for the first time when it is about two 
weeks old. In the fall, winter or spring it is advisable 
to wait until the baby is three months old before 
taking it out even on a pleasant day. It will, however, 
be benefited by a half hour's airing in the nursery or 
other room with the windows partly or wide open, 
according to the temperature. From 10 A. M. to 3 
P. M. is the best time of day for the outdoor airing. In 
cold weather the infant should have additional cloth- 
ing, and chilling prevented by placing hot water bottles 
covered with flannel in the baby carriage or perambu- 
lator. When out for its daily airing the baby's face 
should be covered with a veil, and the top or sunshade 
of the carriage so arranged that the sun cannot shine 
directly into its eyes. If well protected from cold, 
wind or sun the baby will derive a world of benefit 
from sleeping outdoors for a few hours each day. 

TEETHING— DENTITION 

The first teeth, twenty in number, are known as the 
milk, temporary or deciduous teeth, and although there 
may be a great variation both as to the order and time 
of their first appearance the following table may be 
taken as an average : 

Two lower incisors, . . 6 — 9 months 

(lower front teeth) 
Four upper incisors, . . 8 — 12 months 

(upper front teeth) 
Two lower lateral incisors and four ' 

front molars, (double teeth) . 12 — 15 months 



THE INFANT AND ITS CARE 



195 



Four canine teeth, (eye-teeth and 

stomach teeth) . . . 18 — 24 months 

Four posterior molars, . . 24 — 30 months 

(back double teeth) 

When one year old a child should have 6 teeth; at 

V/2 years, 12 teeth; at 2 years, 16 teeth; at 23^ years, 

20 teeth. 

Figure 19 





6-9 Months 



8-12 Months 



.-#«w6saras^g*&^^ 



12-15 Months 



* , sft' in^ 



\ 




18-24 Months 24-30 Months 

Any prolonged illness or rickets may be the cause 
of the teeth coming later than normal. 

Children born with teeth are by no means rare, and 
when such teeth interfere with nursing they should be 
extracted. 



196 PAINLESS CHILDBIRTH 

Some babies cut their teeth without the slightest 
trouble, but as a rule, just when the tooth is coming 
through, the gum becomes painful, hot, red and swollen, 
the baby drools at the mouth and for a day or two is 
slightly feverish, restless, fretful and sleepless. 

The process of teething is very often accompanied 
by derangement of the bowels, and we are to be careful 
how we abruptly check a diarrhoea at the time, lest 
we cause an irritation of the brain and nervous system 
of far more serious tendencies than the diarrhoea. 
Frequently bathing the mouth of the child, cooling 
drinks, etc., will be beneficial, and at the same time, 
if there is diarrhoea, lime water should be added to the 
milk. If the diarrhoea becomes too profuse, employ 
the remedies as directed under diarrhoea. If there are 
symptoms of disturbance of the brain, control with 
gelseminum. This will be better than opiates, thus: 

Fluid Extract of Gelseminum, . 2 drops 
Water, ..... 2 ounces 
Dose — A teaspoonful every one or two hours. 

If there is fever, add aconite to it, thus: 

Fluid Extract of Gelseminum, . 2 drops 
Tincture Aconite, ... 2 drops 
Water, ..... 2 ounces 
Dose — One teaspoonful every one or two hours. 

The child should have something to bite on at the 
same time to aid in bringing the teeth through. I have 
found such a course satisfactory in nearly all cases. 

The milk teeth frequently require attention, and the 
child should at regular intervals be taken to a dentist. 
He is often able to repair the teeth and prevent dis- 
figurement. 



THE INFANT AND ITS CARE 197 

The permanent set of thirty-two teeth arrives as 
follows : 

First molars, . . 6 years 

7- 8 years 



Incisors, . 
Bicuspids. 
Canines, . 
Second molars, 



9-10 years 
12-14 years 
12-15 years 



. Third molars, (wisdom teeth) 17-25 years 
WEANING 

It is often a question of considerable importance 
when to wean the little one. Nothing is gained by 
nursing too long when no circumstance demands it, and 
on the other hand there may be danger in weaning 
it too early. As a rule, it should be started at nine or 
ten months and completed at one year. Begin by 
giving one feeding each day from a bottle; later, two, 
and so on gradually until the baby no longer requires 
to be nursed. The change should be gradual rather 
than abrupt. Should the mother become pregnant 
again during nursing it will be best that weaning take 
place at once. When menstruation returns during 
lactation, the milk is often altered in character, but 
unless the child is affected and begins to suffer from 
indigestion, colic, diarrhoea or loss of weight it should 
not be weaned. 

The season for weaning is important. During the 
hot weather, intestinal disorders are most prevalent, 
and any digestive irregularity it is known will generally 
give rise to diarrhoea and other disorders of a similar 
nature, and unless some circumstance renders it impera- 
tively necessary it is not best to wean during hot 
weather nor just preceding it. The mother should 
arrange to wean early in spring, so that the child may 
become accustomed to different food before the hot 



198 PAINLESS CHILDBIRTH 

months, or she should defer weaning until those months 
during which there is the greatest infant mortality 
have passed. To wean infants in a city in hot weather 
is fatal in a very large per cent of cases. Cow's milk 
in the cities in summer is always a question of serious 
investigation, and no matter how carefully managed, 
it is certain if the milk is all right when it leaves the 
dairy, by the time the infant gets it, it will have been 
influenced to some extent. The country is certainly 
the place for babies in the summer. 

NURSERY DISCIPLINE 

As a rule, children are more intelligent and observing 
than supposed, and they quickly form habits that are 
not easily broken. They seldom thrive well when peev- 
ish or fretful, while good-natured children are most 
generally healthy. Their dispositions are naturally 
cheerful and joyous, unless sickly, neglected or mis- 
managed. The following remarks are well worthy the 
attention of mothers : 

The entire system of nursery discipline, too, has a direct 
tendency to call into action at an early age the passions of the 
child, rather than to still them or direct them in their appro- 
priate channels. At one time it is dandled and coaxed in order to 
quiet it ; at another it is scolded and beaten for the same purpose. 
We either do what it desires or compel it to do what we like. 
We comply with its whims or make it submit to ours. 

Thus no medium is observed, and the child is doomed to be 
always giving orders or receiving them. Accordingly, the first 
ideas it forms are those of dominion or slavery; before it can 
speak it commands; before it acts it obeys; and sometimes it 
is corrected before it is conscious of faults or even before it is 
capable of committing any. We thus implant in its tender mind 
those passions which are afterwards unjustly attributed to 
nature: and having taken pains to render it depraved we com- 
plain because we find it so. N 



THE INFANT AND ITS CARE 199 

But a peevish and fretful disposition in infancy sometimes 
arises from too close confinement in stagnant and impure atmos- 
pheres, impairing the energies of the system, impeding digestion 
and subjecting the sentient organs to impressions if not posi- 
tively painful at least uncomfortable. The remedy consists in 
removing the cause. All attempts to prevent or soothe the 
fretfulness of an infant by cakes, sweetmeats and confectionery 
should be prohibited. The child soon acquires a morbid appe- 
tite for such things, which is ruinous to its health, and it soon 
learns to cry and fret in order to obtain them; nor should chil- 
dren when they happen to fall or experience disappointment of 
any kind be soothed by expressions of extreme pity and sorrow, 
and be allowed in order to hush its cries some foolish indulgence. 
Nothing tends more certainly to encourage a fretful, complain- 
ing and exciting disposition or to induce violent and long-con- 
tinued paroxysms of crying for the most trifling causes. 

Fear, of the most intense description, causing immediate in- 
jury to health and often producing a lamentable degree of feeble- 
ness of character in after life is not unfrequently excited and 
cherished in children by the reprehensible conduct of parents 
and nurses in attempting to render them quiet, or enforce their 
obedience to commands given them by threatening with a visit 
from some object of terror. As we are liable to be ruled often 
by the influence of incidents and impressions subject to revival 
by associations, when the causes which first produced them are 
remembered no longer, how studious, therefore, ought those who 
have the care of children to be, that no impressions be made on 
their minds which should bias their affections, mislead their 
judgments or render nugatory their best resolves, to the end of 
their lives. We ought to be careful before punishing a child for 
obstinacy that its fault really arises from its own wilfulness and 
not from childishness or inability to do what you bid it. Inad- 
vertency, forgetfulness, unsteadiness and wandering of thought 
are the natural faults of childhood and, therefore, unless ob- 
served to be wilful are to be mentioned softly and gained upon 
by time. Children, if properly trained from their birth, are far 
more docile than the generality of parents are inclined to believe; 
and at a very early age can distinguish between what is reason- 
able and unjust in our behavior toward them. They should, 



200 PAINLESS CHILDBIRTH 

therefore, be treated as rational creatures, and be made sensible 
by the mildness of our carriage and by the composure even in 
our correcting them that what is done is reasonable in us and use- 
ful and necessary for them; and that it is not out of caprice, 
passion or fancy that they are commanded or forbidden anything. 

Anger is the most readily excited passion in childhood. Its 
immediate efforts are in the highest degree prejudicial to health, 
by determining to the head an undue amount of blood. It is 
very often the result of having frequently witnessed the exhibi- 
tion of violent passions in those who surround it. Crying, scream- 
ing and various gesticulations of the limbs and body are the 
means by which the passions of anger and other violent emotions 
are generally expressed in infancy. 

Sometimes, when a child begins to cry, to pacify it a stick is 
offered it to beat the "naughty stool" or "stove" that made it 
stumble; with this the child may be quieted, but thence it in- 
stinctively acquires the disposition to revenge itself on whatever 
gives it uneasiness or inconvenience, whether things or persons; 
and thus the desire for revenge is so deeply implanted in the 
mind as scarcely ever after to be entirely eradicated. Parents 
often truly wish their children to do well, but by their own exam- 
ple implant in their offspring the seeds of many a vice. 



CHAPTER XV 



FEEDING THE BABY 

The experience of ages and the dictates of common 
sense all unite in declaring that the most natural food 
for a new-born infant is its mother's milk, provided 
she be in a proper state of health. Every mother should 
nurse her baby, unless there are strong and sufficient 
reasons why she should not do so. The child should 
not be nursed by a mother suffering from tuberculosis, 
Bright's disease, advanced heart disease, epilepsy, in- 
sanity, diabetes, pneumonia, typhoid fever, abscess of 
the breast, erysipelas, scarlet fever or other conta- 
gious or severe disease. 

If for any reason the mother cannot or will not nurse 
her child the best substitute is a wet nurse (see page 193). 
When a proper nurse cannot be secured, recourse must 
be had to either mixed or artificial feeding. 

Mixed feeding is the giving of an artificial food from 
a bottle in addition to nursing from the breast, and is 
often advisable when the breast milk is insufficient or 
when given at night to allow longer rest for the mother. 
It is a good plan to have the baby from the very outset 
take one or two feedings each day from a bottle. In 
case of severe illness of the mother and at weaning 



202 PAINLESS CHILDBIRTH 

time it then becomes a much easier matter to change 
to entire bottle feeding. 

As a substitute for the mother's nurse, cow's milk 
modified or altered according to fixed rules is recog- 
nized as the best for general use. 

BREAST-NURSING 

The child should be taught the habit of seeking the 
breast at regular intervals. This is easily done, if 
undertaken at the commencement. We are more or 
less creatures of habit, and it is much easier to form 
a habit than to break one. Babies learn quickly and 
unlearn with difficulty. 

On the first day, after the mother has had several 
hours' rest and sleep, the infant should be nursed every 
six hours; on the second day, every four hours. From 
the third day to the end of the first month the nursings 
should be every two hours from 7 A. M. to 9 P. M., 
with two night nursings at 12 and 4 A. M. From the 
first month until baby is a year old, the intervals be- 
tween the nursings should be the same as those men- 
tioned under artificial feeding (page 205.) 

Each nursing should last about twenty minutes, 
and if the milk is abundant the breasts should be 
nursed alternately, otherwise, both breasts should be 
used. The infant should not be allowed to fall asleep 
with the nipple in its mouth, but as soon as it has finish- 
ed nursing should be placed in its crib or separate bed 
and allowed to sleep. 

A good color, sound sleep, steady gain in weight and 
normal stools are the best evidences that the milk or 
nurse is agreeing with the baby. When, notwithstand- 
ing regular and proper feeding, it fails to increase in 
weight, is colicky and suffers from diarrhoea with green, 



FEEDING THE BABY 



203 



curdy stools, the question of weaning, and raising it 
on artificial food must be carefully and thoughtfully 
considered. 

ARTIFICIAL FEEDING 

The composition of cow's milk is so different from 
that of mother's milk that it must be modified or al- 
tered by changing the proportions of its various ingre- 
dients so that it will closely resemble mother's milk 
and become suitable for baby's digestion. The exact 
proportions of the different ingredients of modified 
milk must necessarily vary according to the age, weight 
and physical condition of the baby, and the following 
formulae, as advised by Dr. Holt, are given to act as 
a guide to the mother: 

Formula I (third to fourteenth day). 



Ingredients. 



Milk (ounces) 

Cream (ounces) 

Limewater (ounces) 

Water (ounces) 

Milk sugar (even tablespoonfuls) 



QUANTITY OF EACH REQUIRED 
TO MAKE 



12 oz. 


16 oz. 


20 oz. 


24 oz. 


1 


U4 


m 


2 


1 


IX 


iy 2 


2 


u 


1 


IH 


m 


VX 


12H 


15*4 


isy ? , 


w 


2 


2V 2 


3 



Formula II (second to sixth week). 



Ingredients 



Milk (ounces) 

Cream (ounces) 

Limewater (ounces) 

Water (ounces) 

Milk sugar (even tablespoonfuls) 



QUANTITY OF EACH REQUIRED 
TO MAKE 



20 oz. 24 oz. 28 oz. 32 oz. 



2 

2 

2V 2 



2V 2 
2V 2 

iy 2 
i7y 2 

3 



3 
3 

iy 2 

2oy 2 

sy 2 



2 

23^ 

4 



204 



PAINLESS CHILDBIRTH 



Formula III (sixth to eleventh week). 



Ingredients 



Milk (ounces) 

Cream (ounces) 

Limewater (ounces) 

Water (ounces) 

Milk sugar (even tablespoonfuls) 



QUANTITY OF EACH REQUIRED 
TO MAKE 



24 oz. 


28 oz. 


32 oz. 


36 oz. 


3 


w* 


4 


4** 


3 


'& l A 


4 


4** 


W 


1H 


1% 


IV?. 


16** 


19** 


22** 


25** 


3 


3** 


4 


4** 



Formula IV (tenth week to fifth month). 



Ingredients 


QUANTITY OF EACH REQUIRED 
TO MAKE 




28 OZ. 


35 oz. 


42 oz. 


Milk (ounces) 

Cream (ounces) 

Limewater (ounces) 

Water (ounces) 

Milk sugar (even tablespoonfuls 


8 

m 

15 

3^ 


10 
4 

iy 2 


12 

5 

2 
23 

5H 



Formula V (five to ten months). 



Ingredients 



Milk (ounces) 

Cream (ounces) 

Limewater (ounces) 

Water (ounces) 

Milk sugar (even tablespoonfuls) 



QUANTITY OF EACH REQUIRED 
TO MAKE 



30 oz. 36 oz. 42 oz. 48 oz 



\y% 

13M 
4 



13^ 

4^ 

IK 

16^ 

4^ 



15^ 

2 
19 

5H 



18 

6 

2 
22 

ey 2 



Directions for preparing any of the above formulae: 

Disolve the sugar in boiling water, and filter if necessary. 
Add the milk, cream and limewater, and mix the whole in a 
pitcher. 

A sufficient quantity of food to last 24 hours should 
be prepared at one time. This quantity is divided into 
the number of feedings required for the day; each 



FEEDING THE BABY 



205 



feeding being put in a separate bottle and the bottle 
stoppered with absorbent cotton. The bottles should 
then be cooled rapidly, by standing first in tepid, then 
in cold water, and afterwards placed in an ice chest. 
If the milk is to be sterilized or pasteurized this should 
precede the cooling. 

When needed for feeding, the bottle should be taken 
from the ice chest and warmed by standing in warm 
water which is deep enough to cover the milk in the 
bottle; it should then be thoroughly shaken and the 
nipple put on. The temperature of the milk for feeding 
should be about 100° F. — a few drops poured upon the 
front of the wrist should feel warm, but not hot. A 
knitted bag placed over the bottle will keep the milk 
warm whilst the baby is feeding. The infant should 
lie in the nurse's or mother's arms while taking its 
bottle, and each feeding should last about twenty 
minutes. If fed while in its crib (as it may be after 
the third month) the bottle should be held by the nurse. 

Bottle-fed babies must be fed regularly as to time 
and quantity, and the following table will prove an 
excellent guide to follow: 



Age 


Intervals 
between 

day- 
Feedings 


Number 

of 
Feedings 
at Night 

from 
10 P. M. 
to 7 A.M. 


Number 

of 
Feedings 
in 24 hrs. 


Quantity 
for one 
Feeding 


Quant'y 

in 
24 hrs. 


1st week 


2 hrs. 
2 " 

2 " 

2K" 

3 " 

3 " 

4 " 


2 
2 

1 

1 
1 




10 

10 
10 

8 
7 
6 
5 


1 -lJ^OZS. 

1K-3M" 

2M-3H " 

3 -5 " 

4 -6 " 

5 -7y 2 « 

7 -9 " 


10-15ozs 


2d and 3d weeks . . . 
4th and 5th weeks . 
6th week to 3dmo'th 
3d to 5th month . . . 
5th to 9th month . . . 
9th to 12th month . . 


15-35 " 
25-35 " 
24-40 " 
28-42 " 
30-45 " 
35-45 " 



206 



PAINLESS CHILDBIRTH 



The exact quantity for each feeding will vary slightly 
in different children, and must be determined by care- 
fully watching the effect upon the child's health — the 
color, the gain in weight and condition of the stomach 
and bowels. 

Because the milk of one cow is so likely to change 
in quality from day to day, it is better to use mixed 
or herd milk, provided it is fresh and the cows are 
clean and healthy. 

Certified milk is simply clean milk obtained from 
healthy, well cared for cows, properly fed and well 
stabled. The milk is placed in clean, sterile cans and 
kept at a temperature of 40° F. until it reaches the 
consumer. 

Fresh, pure, clean milk is essential for baby's wel- 
fare, and when there is reason to believe that the milk 




Figure 20 Figure 21 

has not been kept at a proper temperature or has been 
handled by unclean hands or exposed to the germs of 
typhoid fever, scarlet fever, diphtheria or other infec- 
tious disease, it should be sterilized — that is, heated, 



FEEDING THE BABY 



207 



in order to kill the germs. Two methods of heating 
milk are in common use — one known as sterilizing, 
where the milk is heated in an Arnold sterilizer (Fig. 
20) to a boiling temperature (212° F.) for 1 to V/2 hours; 
the other as pasteurizing, where the milk is heated in 
a Freeman pasteurizer (Fig. 21) to 155° or 160° F. 
for half an hour, and rapidly cooled by placing the 
bottles in cold water. Sterilized milk is hard to digest, 
quite constipating and has lost much of its value as 
a food. Pasteurized milk has not the same objections 
and is therefore to be recommended for general use. 
It must, however, be understood that milk even after 
being pasteurized must be modified as advised in pre- 
vious paragraphs. 

The nipples should be of black rubber, with the 
holes just large enough to allow the milk to drop easily 
from it when the nursing bottle is inverted. After 
being used, the nipple should be washed in cold water 
or placed in a solution of boracic acid. Before placing 
it on the bottle, the nipple should be warmed by dipping 
it in warm water. 

NURSING BOTTLE— RUBBER NIPPLE 
The feeding bottle should be of such shape 
that it can be easily and thoroughly cleaned. 
(Fig. 22) . Any milk left in the bottle after nur- 
sing should be thrown away, the bottle filled 
with a strong solution of washing soda, and set 
aside for several hours. With a bottle brush it 
should then be well washed inside and outside, 
thoroughly rinsed in boiled water and placed 
mouth downwards in the pasteurizer or other 
Figure 22 clean place to drain and dry. 




CHAPTER XVI 



DISEASES OF WOMEN 

The distinguishing characteristics of woman's organi- 
zation render her liable to certain diseases from which 
men are exempt. As these ailments are not necessarily 
associated with gestation, both married and single are 
subject to them. 

A consideration of these matters does not form a 
necessary part of this book, but I have been so repeat- 
edly solicited for a book on diseases of females that I 
have concluded to add this chapter. 

Social customs impose on woman unhygienic condi- 
tions that impair her constitutional vigor and favor 
the development of uterine diseases. Many of them are 
primarily local, but they exert such a profound influ- 
ence on remote parts through the medium of the sym- 
pathetic nervous system that the whole constitution 
suffers; the functions of various organs are perverted 
and the social faculties are deranged to such an extent 
that the woman who was formerly happy and cheerful 
now becomes one of the most miserable of beings. In 
this way derangements of the stomach, liver and kid- 
neys are caused; affections of the brain and nervous 



DISEASES OF WOMEN 



209 



system are produced, dyspepsia supervenes with innu- 
merable symptoms, the blood-making process is im- 
paired and often fatal consumption results. 

All healthy females are subject to a peculiar function 
that recurs periodically about once in twenty-eight 
days, between the ages of thirteen and forty-five. It 
is called the catamenia or menses from mensis, a month, 
and is characterized by the elimination and discharge 

Figure 28 








The pelvic organs, showing the womb, ovaries, fallopian 
tubes, bladder, and ligaments. 

of a sanguineous fluid. This period of menstrual ac- 
tivity is subject to variation in different climates, and 
in even our own, 43 degrees north latitude, remarkable 
instances are recorded where it has appeared much 
earlier or continued much later. It defines the prolific 
period of woman's life, and upon the regular occurrence 
of the function and its proper performance her physical 



210 PAINLESS CHILDBIRTH 

welfare materially depends. The derangements of 
menstruation are divided into three classes, viz.: 
Ammenorrhoea, Dysmenorrhea, Menorrhagia. 

AMMENORRHOEA 

Ammenorrhoea signifies the absence of menstruation 
from other causes than gestation or the natural cessa- 
tion at the end of the prolific period. When menstrua- 
tion fails to appear at the proper age it is called reten- 
tion; when it does not appear at the proper time after 
having been once established it is called suppression. 

Retention is usually due to a delicacy of the consti- 
tution, in which the proper amount of vital stamina 
or nervous energy is absent, diseases of the lungs, liver, 
kidneys, anemia, etc.; or it may be due to disease 
or absence of the ovaries, uterus or vagina. The 
secretion may be prevented from escaping by an 
imperforate hymen. A certain amount of physical 
force is necessary for the performance of any function, 
and if at the time the girl should develop into woman- 
hood anything occurs to lower her vitality it will 
tend to prevent the development of menstruation. 
Every mother should be solicitous for the welfare of 
her daughter at this critical period, for carelessness 
then may cost her life. She should be instructed what 
she may expect at such a time, lest suddenly surprised 
she may do something to her disadvantage. 

The symptoms necessarily depend more or less on 
the cause of the retention. If the ovaries or uterus are 
absent, no menstruation will ever occur, no matter 
what treatment may be tried. If there is imperforate 
hymen or occlusion of the mouth of the uterus there 



DISEASES OF WOMEN 211 

will be the usual monthly disturbance, but the secre- 
tion cannot escape. In such cases there will be local 
pains and, as it goes on, a fullness, distention, a sen- 
sation of bursting, straining at stool and when urina- 
ting, enlargement, etc., etc. The obstruction being of 
a mechanical character, surgical measures to establish 
the passage will be needed and must not be delayed 
too long. 

When due to constitutional causes there will be a 
pale, sallow, waxy, sodden, sickly appearance of the 
complexion, the tongue furred, breath offensive, appe- 
tite variable, morbid cravings, nausea, general debility, 
easily fatigued, languor, pain in the back and limbs or 
bowels, cold feet, wasting of flesh, dyspeptic symptoms, 
constipation, palpitation, despondency, vertigo, head- 
ache, noises in the ears, and perhaps leucorrhoea, nose- 
bleed, etc., etc. 

Debility is the type of this condition, and remedies 
to invigorate — to build up — must be employed. At 
the same time we must attend to the correction of 
any functional disturbance that may occur. The blood 
is impoverished, there is anemia, and iron is generally 
needed, and as digestion is usually weak and the appe- 
tite poor it can be combined with a bitter tonic with 
advantage. A good and pleasant formula is: Elixir 
calisaya iron and strychnia, a teaspoonful before each 
meal, or compound elixir of phosphates is a good form 
in the same doses. They may be changed, giving one 
for a week and then the other: In some cases the addi- 
tion of a little arsenic in the form of Fowler's solution 
materially increases the beneficial influence of the 
medicine. My prescription then would be: 



212 PAINLESS CHILDBIRTH 

Compound Elixir of Phosphates, 8 ounces 

Fowler's Solution, ... 1 dram 

Dose — A teaspoonful before each meal. 
Aloes has for many years enjoyed an excellent repu- 
tation in such cases; it improves nutrition, overcomes 
the constipation and favors the development of men- 
struation. Its disagreeable taste is the greatest objec- 
tion. The following formula is a good one, not unpleas- 
ant and can usually be procured anywhere: 

Sulphate of Cinchona, . . J^ dram 

Red Carbonate of Iron, . . 1 dram 

Aqueous Extract of Aloes, . 5 grains 

Sugar in powder, . . . 1 dram 

Mix thoroughly and make thirty powders and take one three 
times a day. 

If palpitation is annoying, in addition give three 
to five drops of the homeopathic tincture of cactus 
grandiflorus in water three or four times a day. 

When the nutrition and blood-making process has 
been improved by the foregoing agents, we may begin 
the use of remedies that have a direct influence on the 
uterine functions, as the senecio gracilis — also called 
female regulator, life root, squaw root, unkum, etc. 
It may be given in an infusion or fluid extract or 
homeopathic tincture ten to twenty drops three times 
a day in water or syrup. Dr. Dye's Mitchella Com- 
pound is, however, the best of all tonics for the 
womanly organs and we always advise that it be used 
in cases of this kind. 

Forcing medicines are not advisable. All through 
the treatment give a nutritious diet that is easy of 
digestion, out-door exercise, pleasant scenery, riding, 
etc. Abstain from labor, study or anything that 
exhausts. 



DISEASES OF WOMEN 213 

Suppression may arise from various causes, the most 
frequent of which are pregnancy or sudden cold. It 
may also be due to debility, to plethora, fevers or 
various diseases. When due to pregnancy it is not 
to be regarded as a disease. Suppression may occur in 
the most robust constitutions as well as in the weakly, 
while retention is almost always a consequence of de- 
bility. When suppression is developed gradually, the 
derangement increasing from month to month, it is 
generally due to some other disease, as consumption, 
etc., and the treatment must be selected with a view 
to overcome those conditions as well as to regulate 
menstruation. 

Abrupt exposure to cold, getting wet at the period, 
violent mental emotions cause sudden suppression. 
The flow may be suddenly arrested or, these causes 
occurring at the end of the period, the next return of 
the same may not take place at the proper time. Such 
cases require prompt and efficient measures. When 
sudden cold is the cause, the uterus and ovaries are in 
a state of congestion and we should employ remedies 
to relieve the circulation. A hot hip bath, alcoholic 
vapor bath, hot mustard foot bath and hot appli- 
cations to the lower abdomen are always beneficial; 
then internally give: 

Tincture of Aconite, . . . 15 drops 

Tincture of Belladonna, . . 5 drops 

Tincture of Pulsatilla, . . 60 drops 

Water, ..... 4 ounces 

Dose — Give a teaspoonful every hour and alternate with a tea 
of serpentaria, also known as Virginia snake root. 

Usually in a few hours there will be sweating, relief 
from the fever and pain, and the flow will be re-estab- 
lished. 



214 PAINLESS CHILDBIRTH 

If due to plethora, the use of laxative medicines, 
such as Epsom salts, to act on the bowels, and repeated 
frequently is almost always advisable. At the same 
time give : 

Bromide of Potassium, . . 1 ounce 

Fluid Extract Black Cohosh, . 3^ ounce 

Fluid Extract Ergot, . . J^ ounce 

Syrup and Water, each, . . 3 ounces 

Making in all eight ounces, and take a teaspoonful three or 
four times a day throughout the interval, and as the time for 
the flow approaches give aconite in one-half drop doses every 
two hours for two or three days till the flow is established. 

In lymphatic constitutions give : 



Iodide Potash, . 


1 ounce 


Fluid Extract Black Cohosh, 


Yz ounce 


Fluid Extract Senecio, 


1 ounce 


Simple Elixir, . 


6 ounces 



Mix. Take a teaspoonful three or four times a day. 

In anemia give the remedies advised for retention — 
iron, good diet, etc. In such cases a woman does not 
menstruate because she has not the blood to spare. 

Menstruation is frequently irregular both as to the 
time of occurrence and the quantity and quality of 
the discharge. It may be too frequent or too long 
delayed. It may be too much or too little, and some- 
times there will be at the period a colorless fluid instead 
of the natural discharge. These deviations from a 
natural standard are symptomatic and are to be treated 
accordingly. When too frequent, the ovaries and uterus 
suffer from an irritable or excitable condition and are 
apt to be congested by slight causes, and I would advise : 



DISEASES OF WOMEN 215 

Tincture of Belladonna, . . 15 drops 

Tincture of Apis, . . .10 drops 

Water, ..... 4 ounces 
Take a teaspoonful four times a day. 

Avoid too long-continued exertion on the feet, ex- 
citement, etc., and use the cool hip bath daily. If the 
ovaries are sore and painful on making pressure just 
inside the point of the hips alternate the above pre- 
scription with : 

Bromide Potash, ... 1 ounce 
Tincture Blue Cohosh, . . J^ ounce 

Tincture Nux Vomica, . . 1 dram 

Simple Elixir, to make 8 ounces 

Dose — A teaspoonful three or four times a day. 

When the menses are delayed and scanty, showing 
ovarian and uterine torpor, remedies to stimulate this 
function are necessary, and if there is debility or anemia 
combine them with iron: 

Fluid Extract Helonias, . . 1 ounce 

Fluid Extract Senecio, . . 1 ounce 

Fluid Extract Aloes, . . 1 dram 

Simple Elixir, .... 6 ounces 
Dose — A teaspoonful three times a day. 

If anemia exists give: 

Citrate of Iron and Quinine, . 1 dram 
Simple Elixir, . . . .4 ounces 

Dose — A teaspoonful after meals. 

When the period should occur, a tea of mother- 
wort (also known as leonurus cardica) may be drank 
freely for several days, or, better still, Dr. Dye's 
Mitchella Compound may be used according to direc- 
tions for such cases. 

DYSMENORRHOEA 

Dysmenorrhoea signifies difficult or painful men- 
struation. A very great proportion of the women of 



216 PAINLESS CHILDBIRTH 

the present experience pain at this time, varying in 
intensity from a slight uneasiness to the most excru- 
ciating agony. The character and even the location 
of the pain varies greatly in different persons and is 
materially influenced by the cause. There are four 
varieties of the disease, known as neuralgic, inflamma- 
tory, membraneous and mechanical, and cases are often 
met in which the three varieties seem to be blended 
in one. 

The neuralgic variety is most likely to be met in 
women of nervous temperament, in delicate health, 
and may occur at almost any period of menstrual life. 
The pain is often referred to the ovary, perhaps ex- 
tends to the back and thighs and is often intense. 
Cold, mental emotions, sexual abuses, shocks and any- 
thing that excites or exhausts the nervous system may 
induce the attack. The treatment consists in relieving 
the pain at the attack and improving the general condi- 
tion during the interval. The relief of the pain usually 
requires hot sitz baths, hot vaginal douches and some- 
thing of a narcotic or anodyne character, and as much 
as I object to the indiscriminate employment of such 
drugs, the relief they afford must, when necessary, be 
the excuse for their administration. Five grains of 
phenacetin every four hours for three or four doses 
usually relieves the pain, or the following prescription 
may be tried : 

Tincture of Belladonna, . . 15 drops 

Tincture of Pulsatilla, . . 30 drops 

Water, ..... 2 ounces 

Give a teaspoonful every hour until relief is obtained or the 

belladonna manifests its characteristic effect by dryness of the 

throat or dilatation of the pupil of the eye, when it should be 

suspended or given at longer intervals. 



DISEASES OF WOMEN 217 

The hypodermic injection of one sixth or one quarter 
grain of morphia given by a physician is almost always 
reliable when all else fails. A suppository may be intro- 
duced into the rectum or vagina containing: 
Opium, ..... 1 grain 
Extract of Belladonna, . . 3^ grain 

Cocoa Butter, .... 10 grains 

This will generally give speedy and lasting relief. 
During the interval an effort must be made to improve 
the constitution so that another attack may not occur. 
Avoid tea and coffee and all stimulating diet, excite- 
ment, sexual relations, etc. Take salt water baths with 
friction, plenty of out-door exercise, etc., etc., and 
use this tonic: 

Compound Syrup of the Hypophosphite, 7 ounces 

Tincture of Cimicifuga, . . . .5 drams 

Tincture of Nux Vomica, . . .1 dram 

Dose — A teaspoonful three or four times a day. 

During the week immediately preceding menstrua- 
tion give the above prescription of belladonna and 
Pulsatilla in teaspoonful doses three times a day or, 
better still, Dr. Dye's Mitchella Compound. 

In the inflammatory variety there will be more or 
less of the general symptoms considered under chronic 
inflammations of the womb. The pain generally be- 
comes worse when the flow is being established, grad- 
ually increasing till it reaches its height, and as the 
flow depletes the vessels of the uterus it subsides. There 
is generally more or less constitutional disturbance, 
dragging pain in the hips and back that is not entirely 
relieved between the periods, headache, leucorrhcea, 
etc. This form is often associated with a rheumatic 
condition. 



218 PAINLESS CHILDBIRTH 

The treatment of this form of the disease will be 
more fully explained when the consideration of chronic 
inflammation of the womb is reached. Among the 
other means employed will be the hot sitz bath, hot 
mustard foot-bath, hot vaginal injections, hot appli- 
cations to abdomen, the use of opium and belladonna 
suppository at the period and just previous to the men- 
strual return, the glycerine and cotton tampon, medi- 
cated or not as may be desired. In using the injection 
use a fountain syringe, which pvery lady should have, 
and continue the flow as hot as it can be borne for half 
an hour or longer. It usually gives great relief. In 
the use of the tampon it should be begun three or four 
days before the anticipated trouble and continued until 
the flow begins. (For a further description see chronic 
inflammation of the womb.) For a week before the 
period commences take the following: 

Tincture of Cimicifuga, . . 2 drams 

Tincture of Aconite, . . .15 drops 

Tincture of Belladonna, .10 drops 

Water, ..... 4 ounces 
Dose — A teaspoonful four or five times a day. 

The cure must be effected in the interval, as the 
measures adopted at the period can only palliate at best. 

Membraneous dysmenorrhoea is attended with 
great suffering, and with various modifications consti- 
tutes a large proportion of all the cases of painful men- 
struation. It is characterized by the formation and 
expulsion of clots of dark blood, shreds of membrane 
and in some cases of complete casts of the lining of 
the womb. 

The suffering in such cases usually comes on from 
one to five days before the flow begins, with f everishness 
and constitutional disturbance, headache, backache, 



DISEASES OF WOMEN 219 

pain in the pelvis, and as it progresses becomes 
periodic and labor-like and is in some cases more severe 
than ordinary childbirth and the female not unfre- 
quently becomes unconscious. The pain is often spas- 
modic, expulsive and tenesmic and continues until the 
flow is fully established and the membrane or clot is 
expelled. As the pain goes on month after month local 
inflammation is developed and adds to the difficulty. 
The general health suffers, the ovaries become con- 
gested, enlarged, extremely sensitive, the nervous sys- 
tem becomes weakened and irritable and the condition 
is one of abject misery. 

The successful treatment of this form requires an 
unusual amount of tact and skill, associated with per- 
severance. Affecting as it does a class of persons among 
whom there is a wide diversity of constitutional pecu- 
liarities, the treatment will have to be varied to meet 
the conditions presented by each individual case. The 
advice already given for relief at the period may be 
used and will no doubt palliate; but it will usually 
be found necessary to resort to opiates or narcotics 
to obtain very marked relief. The following prescrip- 
tion I have found suitable in nearly all cases, affording 
temporary relief when other measures had failed. I 
give the forms of the remedies most generally obtained 
at any and all drug stores: 

Fluid Extract Blue Cohosh, . 3 drams 

Fluid Extract Viburnum, . . 1 ounce 

Fluid Extract Gelseminum, . 30 drops 

Sulphate of Morphia, . . 1 grain 

Simple Elixir, enough to make 4 ounces 

Dose — A teaspoonful every hour till relieved. 

It should be employed before the pam becomes so 
exceedingly severe, and will prevent untold suffering. 



220 PAINLESS CHILDBIRTH 

If it is carried too far, drowsiness and prostration, 
inability to open the eyes, double vision, etc., will 
occur, when it should be stopped for some hours, till 
these symptoms wear off. 

It is during the interval that the treatment must 
be directed to a cure. Dr. Dye's Mitchella Com- 
pound is the remedy to use because it goes right to 
the seat of the trouble and removes the cause of the 
pain. The following prescription will benefit the ma- 
jority of cases: 

Fluid Extract Black Cohosh, . 1 ounce 

Fluid Extract Squaw Vine, . 1 ounce 

Fluid Extract Colchicum Seed, . }/i ounce 

Iodide of Potass, ... 1 ounce 

Simple Syrup or Simple Elixir, . 5 ounces 
Dose — A teaspoonful three times a day. 

If there is debility give in addition to the above a 
good iron tonic or some syrup of hypophosphates 
containing quinine, iron and strychnine that can be 
got at any drug store ready prepared. Some of the 
prescriptions already given containing iron will do. 

If rheumatism is the predominating trouble, in addi- 
tion to the prescription containing colchicum it will 
be well to give alkalies, as the bicarbonate of soda in 
ten or fifteen grain doses several times a day, dissolved 
in a little water. 

Throughout the treatment of such cases a course of 
hygiene is to be carried out looking to the improvement 
of the general health, regular hours, warm clothing, 
baths, good nutritious diet, avoidance of excesses, etc., 
etc. Marriage has often been urged as a means of cure, 
but with little propriety, for seldom has a person been 
benefited when this form of disease exists. 

Mechanical dysmenorrhoea is due to the presence 



DISEASES OF WOMEN 221 

of an obstacle to the exit of the flow. This obstruction 
may depend on a stricture or narrowing of the uterine 
canal or a curvature of the same to such an acute angle 
as to close the passage, to displacement, to the presence 
of a tumor or polypus within the passage or any other 
cause that tends to close the passage. These conditions 
cause sterility as well as dysmenorrhoea. 

In such cases the cramp-like pains will be severe, 
the flow scanty or it may escape in clots or gushes; 
ovaries become tender and irritable and the whole 
system often takes on an irritable condition that is 
extremely unpleasant and annoying. A positive diag- 
nosis can be made only by a proper examination. 

Treatment consists in measures to render the canal 
pervious by the removal of whatever obstruction may 
exist, the dilatation of the passage by dilators, or inci- 
sions to straighten and enlarge the same. Of course 
such measures can be resorted to only by a competent 
physician, so there is no need to enlarge on the subject 
here. The use of warm baths is always useful. Thirty 
drops of fluid extract of viburnum prunifolium every 
three or four hours will give relief, and the use of the 
belladonna prescription already given and Pulsatilla 
are always temporarily useful. In using Pulsatilla, give 
two to five drops every two or three hours. If the 
lining membrane of the womb is inflamed it should be 
curetted or scraped — a very simple operation when 
done by a competent physician. 

MENORRHAGIA 

Menorrhagia signifies profuse menstruation and also 
applies to the unnatural and unusual frequency of its 
return. It may occur at any period of life from puberty 
to old age. It affects all varieties of constitutions, 



222 PAINLESS CHILDBIRTH 

although the sanguine are most liable. Excessive exer- 
tion, debility, organic diseases of the womb and ovaries, 
sub-involution, are fruitful causes. A defibrinated con- 
dition of the blood and plethora are among the most 
frequent sources of the disease. It may also be due to 
such diseases as anemia, tuberculosis, Bright's disease, 
affections of the spleen and liver, heart or lung disease, 
prolonged nursing, anger, grief, passion, excessive 
exertion at the period, sexual excesses, inflammation 
of womb, cancer, tumors and polypi. The symptoms 
vary with the nature of the disease. In mild cases there 
may be more or less debility, a sense of languor, palpi- 
tation, dizziness on exertion, etc., with an increased 
frequency or quantity of the flow. In the severer cases 
the hemorrhage becomes excessive, the countenance 
pale, blanched, great prostration, fainting, feeble and 
rapid pulse, uneasiness, every exertion causing the blood 
to start freely, etc. 

The treatment must be directed to modifying the 
flow at the time and to averting its repetition. 

During the flow, the recumbent position should be 
enforced and a bandage applied around the pelvis and 
abdomen. Then give a tea made of equal parts of 
cinnamon bark, hemlock bark and witch hazel leaves 
steeped strong. Give a tablespoonful every half hour 
or hour, lengthening the intervals as the urgency of 
the symptoms subside. Five to ten grains of gallic 
acid in a tablespoonful of water, either alone or in 
alternation with the tea. Ten drops of the oil of erigeron 
(fleabane) on sugar may be used with the same fre- 
quency of repetition. Either of these three remedies 
is reliable and may be used singly or in alternation. 



DISEASES OF WOMEN 223 

Hamamelis, cannabis indica, aconite, etc., of the homeo- 
pathic school are excellent remedies. Large doses of 
ergot are good in cases where the uterus is large and 
flabby. Give a teaspoonful at once. 

During the interval, measures adapted to the pecu- 
liarities of the case should be instituted. If there be 
anemia or a lack of fibrin in the blood, iron is neces- 
sary. If Bright's disease or affections of the spleen 
exist, treatment appropriate to them is necessary. 

If there is syphilis, an alterative and tonic course is 
needed. If it is due to sexual excesses or abuses it 
must be abandoned, and remedies adapted to over- 
come the nervous prostration associated with this condi- 
tion are to be used. Such conditions should receive the 
attention of a competent physician, as they are so 
variable that prescriptions given here may need to be 
varied more or less. A large proportion of cases need 
a uterine combined with a constitutional tonic, and for 
such the following will be found excellent: 

Fluid Extract Helonias, 
Fluid Extract Senecio, 
Fluid Extract Trillium, 
Fluid Extract Nux Vomica, 
Simple Elixir, . 
Dose — A teaspoonful three times a day. 

Give a nutritious but not stimulating diet, cold 
hip baths, sponge baths, moderate out-door exercise. 
Avoid all excitement. 

If the patient be plethoric she should be given free 
cathartics frequently. If tumors or polypi exist, the 
proper surgical treatment for their removal is necessary. 
VICARIOUS MENSTRUATION 

If at the time when the menstrual period arrives 
a sanguineous discharge from some other part takes 





V2 


ounce 




1 


ounce 




1 


ounce 




1 dram 




5 


ounces 



224 PAINLESS CHILDBIRTH 

place it is called vicarious menstruation. It may occur 
from any part, but usually comes from a mucus mem- 
brane like that of the mouth or nose, but it may also 
come from the nipple or an open sore. It presents all 
the characteristics of the menstrual flow and is usually 
due to a watery condition of the blood. When the 
uterine function is re-established, this vicarious func- 
tion ceases. The treatment generally required is to 
re-establish the natural function, and for this purpose 
emmenagogue remedies are needed, among which 
cotton root in one or two teaspoonful doses of the fluid 
extract three times a day for several days at the ap- 
proach of the period is a good remedy. Also senecio 
gracilis and other remedies advised under ammenor- 
rhoea. If the discharge takes place from the lungs or 
stomach, remedies to control the hemorrhage as well 
as to bring on menstruation may be required. Of 
course any other perverted function should be corrected. 

LEUCORRHOEA 

Leucorrhoea (fluor albus, or "whites," as it is more 
generally called) is one of the most common of female 
complaints. It is characterized by a discharge from 
the female genitals, varying in color from whitish or 
colorless, to a yellowish or light green, to a reddish or 
brownish or even bloody; in consistence, from thin 
and watery to a thick, tenacious, ropy substance; in 
quantity, from a slight increase of the natural secretion 
to several ounces in twenty-four hours. 

It is so general that there are few females who are 
not affected by it at some period of life. It is even met 
with in infancy. It may be so bland as to occasion 
little or no inconvenience, or it may become so acrid 
and corrosive that it will excoriate every tissue with 



DISEASES OF WOMEN 225 

which it comes in contact; and when the virulent form 
occurs in the married it may cause in the husband an 
affection known as balanitis, which bears such a strong 
resemblance to gonorrhoea that unjust suspicions arise 
and occasion much domestic unhappiness. 

The diagnosis of a virulent leucorrhoea from true 
gonorrhoea is made with difficulty and has often given 
rise to serious inquiry regarding the chastity of the 
female. A diagnosis, however, being possible by com- 
petent physicians, hasty or unjust conclusions should 
not be indulged. When this secretion is profuse or 
acrid it is very apt to cause sterility, and not infre- 
quently is the cause of the most excruciating agony 
during the connubial relations. 

For the most part, leucorrhoea is regarded as symp- 
tomatic of some disease of the uterus or vagina of 
either a functional, inflammatory or organic character, 
or it may be indicative of some disorder of the general 
health. 

CAUSES 

Anything capable of lowering vitality predisposes to 
leucorrhoea. It is generally present as a symptom or 
complication of almost every form of uterine disorders. 
Influences that cause inflammation, ulceration, con- 
gestion, laceration and displacement of the uterus, 
menstrual derangement, etc., give rise to and perpetuate 
this disorder. Among the most common causes we may 
mention are luxurious living, sedentary habits, exces- 
sive sexual indulgence, masturbation, abortions, un- 
cleanliness, piles, abnormal growths, prolonged nursing, 
pregnancy, too rapid child bearing, injuries, gonorrhoea, 
cold at the menstrual period, etc. 



226 PAINLESS CHILDBIRTH 

SYMPTOMS 

Among the early symptoms are generally a sense 
of heat and soreness, amounting to pain or smarting, 
and a sense of swelling followed by the development 
of the discharge which may be a white, greenish, yellow, 
brown or reddish hue. The sufferer becomes pale and 
emaciated, her eyes look dull and heavy, there is 
severe and prolonged pain in the back and loins; the 
functions of the skin, stomach and bowels become de- 
ranged, the circulation is impaired, the head hot and 
feet cold; there is a loss of strength and energy, languor, 
pain in the stomach, failure of appetite, headache, 
dyspepsia, nervousness and hysteria. 

As the disease progresses, the blood becomes impov- 
erished and the female weak and emaciated; the feet 
and ankles swell, urination becomes frequent and pain- 
ful, the mind is dejected, the victim becomes appre- 
hensive, despondent and melancholy. This state of 
things produces displacements; sterility and impoten- 
cy result, and the sufferer is reduced to abject misery. 

The disease may be uterine or vaginal or it may be 
a combination of both, and the character of the dis- 
charge as well as the symptoms will depend materially 
upon the cause, the location of the disease and the 
amount of inflammation. 

TREATMENT 

The successful treatment of this affection will depend 
largely upon the recognition and removal of the dis- 
turbance that occasions it, the inculcation of proper 
hygienic regulations and the employment of appro- 
priate remedial agencies. It will therefore be seen that 
the treatment must necessarily vary to suit the indi- 
vidual case. We must have an avoidance of sexual 



DISEASES OF WOMEN 227 

excesses, while the mind must be withdrawn from all 
lascivious ob j ects. Overexertion, fatigue, heated rooms, 
must be prohibited. The most perfect cleanliness 
of the parts must be enforced or our efforts will fail. 
Daily and thorough syringing is essential to success. 
The morbid secretion is more or less irritating of itself, 
and if allowed to remain undergoes decomposition, 
becomes acrid and offensive and is extremely prejudi- 
cial to the integrity of the mucous membrane lining 
these parts. 

We must seek by every means at our command to 
invigorate and improve the condition of the general 
health. Plenty of exercise in the open air, good, nutri- 
tious diet and regular habits are necessary, and when 
other diseases co-exist they must receive appropriate 
attention. 

The employment of injections of tepid water, soap- 
suds, medicated or otherwise, for cleanliness alone are 
necessary and should be repeated at least once a day 
with a fountain syringe that will allow a continuous 
stream to thoroughly irrigate the parts and effectually 
wash away every particle of secretion. 

HOW TO TAKE A VAGINAL DOUCHE 

The woman should lie on her back with knees drawn 
up and the hips raised on a pillow or resting on a douche 
pan. The fountain syringe should be about two feet 




Figure 24 



228 PAINLESS CHILDBIRTH 

above the level of the hips and the douche water warm 
or hot (never cold). The tube or nozzle should be large 
and curved with three small openings on the side near 
the tip. Vulcanite or hard rubber nozzles are the best. 
Before inserting the nozzle in the vagina allow the 
water or medicated solution to run through it to expel 
the air. Care should be taken that the water does not 
get into the womb, as that might cause an attack of 
uterine or womb colic. When given to cure inflamma- 
tion in the pelvic organs the douche water should be 
quite hot, so as to contract the blood vessels and subdue 
the inflammation. A simple cleansing douche may be 
taken at any time, but when only one hot douche is 
needed each day it should be taken just before retiring. 
Much inconvenience and trouble will be saved by taking 
the vaginal douche whilst reclining in a bath tub. 

As an injection, water medicated with carbolic acid, 
ten to fifteen drops to a pint, once a day is excellent. 
When the smell of carbolic acid is objectionable, per- 
manganate of potash may be substituted, half a dram 
to a quart, used freely. 

When the disease is confined to the vagina, astrin- 
gent antiseptic lotions are desirable, of which the fol- 
lowing will usually meet the indications: 

(1) Sulphate of Zinc, ... 1 ounce 
Powdered Golden Seal, . . 3 ounces 

Mix. Put a heaping teaspoonful in a pint of hot water and let 
it stand till lukewarm, and use at once, repeating it at least 
every day. 

(2) Sulphate of Zinc, . . • K ounce 
Borax, ..... 2 ounces 

Directions — One teaspoonful dissolved in one quart of luke- 
warm water and used as a vaginal douche at bedtime. 

(3). One or two teaspoonfuls of iysol in one quart of water 
makes an excellent cleansing and antiseptic douche. 



DISEASES OF WOMEN 229 

Constitutional treatment is essential. Tonics and 
alteratives are needed. At the same time if any func- 
tion is perverted it must be corrected by proper means. 
Give: 

Fluid Extract Stillingia, . . 1 ounce 

Fluid Extract Life Root, . . 1 ounce 

Fluid Extract Black Cohosh, . H ounce 
Fluid Extract Buchu, . . 1 ounce 

Simple Elixir, . to make 8 ounces 

Take a teaspoonful three times a day between meals and at 
night. 

If it has been brought on by sexual abuses and the 
mind full of lewd thoughts, the nervous system irri- 
table, add an ounce of bromide of potass to the above. 

Alternate the above prescription with a good tonic 
before meals. Elixir of calisaya bark and iron already 
mentioned is very appropriate. 

CHRONIC INFLAMMATION OF THE WOMB 

This is a very common affection and one which, 
while it exerts a very important influence on the uterine 
system, is very imperfectly understood and often passes 
unnoticed and neglected. 

Modern society imposes upon woman certain un- 
hygienic customs that impair the vigor of her consti- 
tution and give rise to a variety of imperfect physical 
conditions that are extremely liable sooner or later to 
develop an inflammation of the womb. The disease 
once established, the whole economy suffers; all the 
vital processes are so much modified that a spontaneous 
recovery is very rare. Through the medium of the 
sympathetic nervous system the morbid influence is 
propagated to remote organs, causing complications 
that are often mistaken for the real disease and, as 
may be supposed when such is the case, the treatment 



230 PAINLESS CHILDBIRTH 

is thus rendered a failure. Indeed, so great is the 
influence exerted by this organ on all parts of the body 
that few patients escape these sympathetic phenomena. 

The inflammation may attack any part of the organ, 
and the symptoms will necessarily vary with its loca- 
tion and severity, and as the disease continues un- 
checked or without modification by appropriate reme- 
dial agencies it results in changes in its structure and 
position that occasion a new class of painful and un- 
happy symptoms. 

The causes of this affection are numerous and may 
operate directly to cause the trouble or, by indirectly 
influencing the functional activity of the pelvic organs, 
excite the disease; anything that lowers the vital 
standard predisposes to it. Among the most fruitful 
causes I may mention excessive sexuality, masturbation, 
prevention of conception, improper reading, lascivious 
thoughts, heated rooms, habitual use of cushioned 
seats, stimulating diet, cold at the menstrual period, 
uncleanliness, constipation, sedentary habits, violent 
exertion, tight lacing, abortions, improper manage- 
ment at childbirth, getting up too soon after con- 
finement, piles, inflammation of the bladder, etc. 
SYMPTOMS 

The most prominent local symptoms experienced are 
pain in the back and loins, inability to stand or walk, 
pain in the side and region of the bladder, sense of 
weight and bearing down in the pelvis, sometimes so 
severe as to occasion the most intense agony, and irri- 
tability of bladder. Leucorrhoea is at first light colored, 
but as the disease progresses to ulceration it becomes 
thick, yellow, green, offensive and often bloody. There 
is pain at menstruation, derangement of the flow, 



DISEASES OF WOMEN 231 

cramps, sterility and abortion. The inflammation in- 
creases the weight of the womb beyond the supporting 
power of its attachments, consequently displacements 
occur, occasioning new symptoms and increasing the 
difficulty. The womb becomes very sensitive to the 
touch, tender and painful. By pressure upon the rectum 
it causes constipation, sometimes alternating with 
diarrhoea, piles, etc. As the disease goes on, the ner- 
vous system becomes involved, abnormal sensations are 
experienced in various parts of the body. There is 
excruciating headache, backache, spinal tenderness, 
hysteria, numbness, fainting, palpitation, difficulty in 
breathing, pain under the breast and side, feet and 
hands cold, skin dry and sallow, the stomach and liver 
become deranged, the tongue coated, breath offensive, 
the sufferer becomes feeble, cough develops and there 
may be rapid decline. Sometimes the breasts are af- 
fected. There will be perversion of the intellectual 
faculties, and the victim becomes despondent, nervous, 
fretful and suspicious. 

Sterility is a frequent consequence of the disease. 
The mucous membrane may undergo ulcerative degen- 
eration, and displacements almost invariably supervene 
if it continues unchecked for any great length of time. 

TREATMENT 

Much diversity of opinion exists as to the procedure 
necessary in such cases and it is really an open question 
whether gynecology, as the science of uterine diseases 
is called, is really a benefit or a damage to the sex. If 
the treatment was confined to competent practitioners 
the question would not admit of debate, even if differ- 
ences of opinion existed; but in the hands of the un- 
skillful, as is too often the case, not only is there no 



232 PAINLESS CHILDBIRTH 

benefit obtained from their treatment, but the disease 
may be aggravated and perhaps serious complications 
induced. 

It has become a fashion for physicians to make a 
specialty of " diseases of women,'' and every profes- 
sional tyro believes it is "his forte." He knows such 
ills are prevalent — that they admit of good fees for 
"examinations" and "treatment/' and that woman 
has been schooled to the belief that it takes a good 
while to cure, hence they have unlimited opportunity 
to prey upon the unfortunate. If the majority of such 
doctors were submitted to an examination they could 
neither explain the anatomy of the parts nor diagnose 
the ailment, much less cure the disease. It is for this 
reason gynecology is in danger of losing caste, and 
opens the door to debate whether the harm done by 
the unscientific is not infinitely greater than the good 
the skillful can accomplish. 

Local applications are doubtless good in their place, 
but the indiscriminate employment of caustics and 
what not cannot be too severely condemned. When 
other organs become diseased they are fortunately out 
of the reach of such torture and are cured by other and 
more agreeable means, and many may wonder if the 
liver and kidneys can be cured by other means why 
uterine diseases may not also escape the necessity of 
local torture. The reader may think this is begging the 
question and, while I admit it may be so in some 
cases, the parallel is often but too obvious. 

The object of local applications is for the most part 
to excite healthy action by changing the conditions 
that exist and at the same time modify pain and irri- 
tability. 



DISEASES OF WOMEN 233 

We can excite a change in the condition of the 
uterus, relieve its dilated blood vessels and materi- 
ally lessen its weight by the application of glycerine, 
which may be medicated or not as desired. The glyc- 
erine is to be applied on a pledget of cotton and should 
be renewed every day or every other day. Take a 
piece of cotton wool about the size of an egg, saturate 
it with glycerine and apply it well up against the neck 
and mouth of the womb and allow it to remain. A 
small string may be attached to the tampon to facili- 
tate its removal, and it will be most conveniently 
applied with a pair of dressing forceps through an ordi- 
nary tubular speculum. Many succeed in applying it 
themselves without. The cotton should not contain so 
much glycerine that it can be squeezed out in a stream. 

The result of this application will be to excite a 
profuse watery discharge that will deplete the uterine 
vessels and induce a change in the circulation, reliev- 
ing the congestion with all its dragging and disagreeable 
consequences. When it is removed, thoroughly syringe 
the parts, removing every particle of morbid secretion, 
and repeat the application. 

In long-standing cases, when the womb has become 
enlarged, a little tincture of iodine may be added to 
the glycerine in the proportion of one dram to the 
ounce and applied in the same manner. 

After the congestion and inflammation have been 
reduced by this treatment it will be necessary to follow 
up the advantage gained by the use of astringents and 
tonic applications which may be applied on cotton in 
the same manner. The fluid extract of golden seal or 
witch hazel or pinus canadensis may be mixed with 
glycerine in about equal parts of whichever one is 



234 PAINLESS CHILDBIRTH 

selected and used. As these applications stain the 
clothing, proper precautions to prevent such a conse- 
quence should be taken. This is easily done by a small 
pad of absorbent cotton placed just inside the vagina 
or by wearing a napkin. Sitz baths may be employed 
with great good, but in their use it may be necessary 
to accustom the patient to them. They may be begun 
warm or tepid and the temperature gradually lowered 
until in a few days they are employed cold. They should 
be followed by brisk rubbing to excite vigorous reac- 
tion. When, however, they are intended to relieve 
pain, soreness or excitement they should be used warm 
or even hot. 

The employment of local applications must not, 
however, be regarded as the sine qua non. We have 
several medicines about the remedial influence of which 
on these parts there cannot be any doubt, and their 
employment must not be overlooked. Their combi- 
nation or alternation with agents that control special 
symptoms and conditions that are outgrowths of the 
main disease must constitute an essential feature of 
the treatment. 

The black and blue cohosh, the squaw vine, Pulsa- 
tilla, lady slipper, bromide of potash, etc., may be 
used singly or in combination, for their influence in 
diminishing pain, controlling inflammation and re- 
lieving reflex-excitability. They overcome the nervous- 
ness that almost invariably attends inflammation of 
the womb. Dr. Dye's Mitchella Compound gives 
quicker and surer relief than any other medicine that 
can be used. 

The following prescription is a good one. Take, of 



DISEASES OF WOMEN 235 

the homeopathic tincture or fluid extract, the tincture 
being preferred, thus: 

Tincture of Pulsatilla, . . 1 dram 

Tincture of Black Cohosh, . 2 drams 

Water or Simple Elixir, . . 4 ounces 

Mix. Dose — A teaspoonful three or four times a day. 

After it has been taken two or three weeks substi- 
tute the following: 

Fluid Extract Mitchella Repens, 1 ounce 

Fluid Extract Caulophyllum, . Y /i ounce 
Fluid Extract Cypripedium, . J^ ounce 
Bromide Potass, H ounce 

Simple Elixir, enough to make 4 ounces 

Mix. Take a teaspoonful three or four times a day. 

The use of nux vomica given alternately with either 
the above, on the same day, is advisable. To avoid 
too many medicines it may be given in combination 
with other remedies if any are being given at the same 
time. If there is much breaking down of the system 
in general it may be combined with iron and quinine 
in form of a pill or syrup or, where the nervous symp- 
toms predominate, with phosphorus, thus: 

Tincture Nux Vomica, . . 1 dram 

Quinine, ..... 30 grains 
Syrup Hypophosphites, . . 4 ounces 

Dose — A teaspoonful three times a day, just before or after 
eating. 

It is not usually advisable to continue any prescrip- 
tion too long without a change, or the beneficial effect 
will be lost. For that reason I seldom give large pre- 
scriptions, except the patient lives at considerable 
distance, when I give enough to last a month at a time. 
Special symptoms must always be considered in making 



236 PAINLESS CHILDBIRTH 

prescriptions, and in this disease they are so exceed- 
ingly numerous that not a little tact and judgment 
must be exercised. Constipation is a very frequent 
symptom and one that should not be overlooked. 
Many of the cathartics usually employed increase the 
determination of blood to the pelvis and, therefore, 
should be avoided in all cases. The mix vomica in 
many cases will be all that is necessary. When it is 
insufficient, salines like Rochelle salts, seidlitz powders, 
citrate of magnesia or even some of the laxative waters 
are advisable. Common Epsom salts in small doses 
every morning in some cases do great good. The fol- 
lowing makes a very good aperient and tonic: 

Epsom Salts, . . » . 2 ounces 

Sulphate of Iron, . K ounce 

Cider, ..... 1 pint 

Mix. Dose — A tablespoonful once to three times a day. 

The cider relieves the unpleasant taste of the salts. 
The iron may be left out if the patient is full blooded. 

Trouble with the bladder often demands relief 
temporarily while the real disease is being treated. 
The smarting and burning and frequent desire to uri- 
nate can usually be relieved by: 

Tincture Cantharides, . . 10 drops 

Water, ..... 4 ounces 
Dose — A teaspoonful every two or three hours. 

As soon as relief is obtained it should be omitted. 
The headache will generally yield when the cause is 
removed, but during a severe attack thirty grains of 
bromide of potass dissolved in a wineglassful of water 
may be taken and repeated in two hours if need be. 

The sitz bath is an agent of great value and should 
always be employed as an adjunct to other measures. 



DISEASES OF WOMEN 237 

The directions given for its use in this and in a preced- 
ing chapter are equally appropriate. Copious hot water 
douches should be taken morning and night. A change 
of habit is beneficial. Indolence must not be tolerated 
and, on the other hand, excessive labor should be 
avoided. Rest, especially during menstruation, is very 
helpful. Heavy lifting is to be prohibited, as it would 
be very likely to cause displacement. Marital relations 
must be suspended entirely or nearly so and care must 
be exercised to avoid any circumstance that could 
cause any form of sickness on account of its liability 
to aggravate the disease being treated. 

Perseverance is necessary for success, and as improve- 
ment progresses carelessness cannot be indulged. I 
have seen the slightest indiscretion cause a relapse as 
severe as the original disease. Occasionally there will 
be cases so obstinate or complicated as to demand the 
greatest professional skill, and no general rule can be 
written that will suit all. I have endeavored in this 
chapter to avoid advising such measures as would be 
impracticable and have necessarily confined myself to 
more simple and easily applied forms of treatment, 
and should any one find the directions inadequate to 
meet all the contingencies that grow out of so varied 
and troublesome a disease I will be pleased to consider 
the case in its individuality and render such service 
or advice as may lead to its cure. 

I have purposely omitted a discussion of the varie- 
ties of inflammations and their divisions by localization, 
as such a consideration could only result in confusing 
the unprofessional. To them the fine distinctions as 
to whether the inflammation is limited to the mucous 



238 PAINLESS CHILDBIRTH 

membrane of the uterine neck or to the deeper struc- 
tures, whether these conditions are confined to the neck 
of this organ or whether they extend to and involve 
the whole or only a part of its body is a matter of no 
practical value, as the symptoms would not enable 
them to diagnose or even treat the matter with any 
material difference; for this reason they have been 
omitted, and not because, as some critical individuals 
may claim, on account of carelessness or indifference. 

ULCERATION 

This is a frequent result of inflammation and pre- 
sents several varieties, varying from a slight abrasion to 
a deep-seated intractable sore. It may be limited to a 
superficial ulceration or erosion of the mucous mem- 
brane of the neck or mouth of the womb, or it may 
extend into the body of the organ and into the deeper 
tissues. This is one of the great hobbies of the so- 
called " specialist " and if the patient's financial capa- 
bility admits, " ulceration " is found. Do not understand 
me as denying the existence of such a disease, but that 
it is not always present. It is likely to result when the 
inflammation has continued for a long time unchecked 
or been improperly treated. It indicates impairment 
of vitality, either local or general or both. The degen- 
eracy of tissue may be local, but cannot exist long 
without more or less injury to the general health if, 
indeed, the general health has not been materially 
impaired before the ulceration occurs. 

The symptoms will necessarily differ, according as the 
ulceration is superficial or deep, limited or extensive, 
and will accord more or less with those already described 
under chronic inflammation. There will be leucorrhcea, 
varying from slight milky, watery or colorless to thick, 



DISEASES OF WOMEN 239 

tenacious, purulent, green, lumpy or bloody. There 
will be pelvic and sacral pains, backache, ovarian 
irritation, dyspepsia, irregular menstruation, menor- 
rhagia, neuralgia, pains in various parts, irritation of 
the bladder and rectum, debility and more or less dis- 
turbance of the general health. A positive diagnosis 
without the speculum is impossible, the employment 
of which reveals the presence or absence of the ulcer 
and its character. A celebrated writer has said: 

Treatment of uterine ulcer is one of the most important and 
difficult in the whole range of medical science. 

We must be guided by the character and extent of 
the ulcer, the existing inflammation and the state of 
the general health. The employment of local measures 
is necessary. Caustics, stimulants, astringents, etc., 
must be selected with care. In mild cases, carbolic 
acid applied full strength or nitric acid applied on a 
pine stick dipped in the acid and allowed to dry before 
applying, will generally suffice; but in more deeply 
seated sores more vigorous treatment may be neces- 
sary — caustic potash, solid nitrate silver, chromic acid, 
etc. When applying them, the adjacent parts must 
be carefully protected. It is always best to employ 
a physician who understands such diseases and who is 
provided with proper facilities and who will necessarily 
conduct the subsequent treatment. In mild cases, fluid 
extract golden seal or pinus canadensis may be applied 
on lint and changed daily, with injections to thoroughly 
cleanse the parts, and then repeat the applications. 
Daily vaginal douches of lysol solution (one teaspoon- 
ful of lysol to one quart of water) are cleansing and 
antiseptic; healing injections of an infusion of white 
pond lily root, golden seal and witch hazel with chlorate 



240 PAINLESS CHILDBIRTH 

of potash one half ounce to the quart are useful and 
may suffice in the milder cases. 

Some physicians apply an iron devised for the pur- 
pose, heated to a white heat. Some apply tincture of 
iodine and follow with the glycerine and cotton dressing 
already described under inflammation. The plans of 
treatment are as various as physicians are numerous, 
and as the afflicted are not apt to try it themselves 
minute description is not necessary. 

Whatever local measures are adopted, the plan is to 
destroy the ulcer and make a healthy sore, or to so 
stimulate the tissues in which it is seated as to bring 
about a healthy action. 

As already remarked we will usually find an impair- 
ment of the general health which must be built up or 
we cannot hope to succeed. It is impossible for a sore 
to heal while the blood is impoverished and impure, 
the fluids of the body perverted and the nervous sys- 
tem morbidly acute. Inculcate thorough hygiene, open 
air exercise, salt water baths, generous but unstimu- 
lating diet, regular habits, avoidance of fatigue and 
sexual relations, then take the following: 

Fluid Extract Corydalis, 
Fluid Extract Cypripedium, 
Fluid Extract Hydrastis, . 
Fluid Nux Vomica, . 
Simple Elixir, . 
Dose — A teaspoonful before meals three times a day. 

This may be advantageously alternated with ten to 
fifteen drops of dialized iron in water three times a 
day. Build up the vital forces by every possible means. 
At the outset, understand, time and perseverance are 
necessary. The foregoing are but a few of the many 



1 ounce 


1 ounce 


1 ounce 


1 dram 


5 ounces 



DISEASES OF WOMEN 241 

remedies at our command which come under the gen- 
eral classifications of alteratives and tonics and are 
useful in depraved conditions of the system, but as 
these cases seldom undertake to conduct their own 
treatment they are probably sufficient to indicate the 
character of the treatment needed in a general way. 

DISPLACEMENTS 

There are three principal varieties of uterine dis- 
placement: Downward (prolapsus), backward (retro- 
version), forward (ante-version). A slight deviation from 
the normal position may occur without occasioning any 
very serious trouble, but as the degree of deviation is 
increased the trouble arising from such displacement is 
augmented. Displacements to one side may occur, but 
are not so frequent. Two other forms of displacement 
are met with in which the neck remains in its natural 
position and the body is displaced. This, of course, 
necessitates a bending of the neck. When the body 
is tipped backward it is called retro-flexion; forward, 
ante-flexion. 

Displacements are usually complications and effects 
of inflammation, lacerations or tears of womb, sub-in- 
volution after labor or miscarriage, tumors, although 
they may be produced by getting up too soon or at 
work too early after confinement, heavy lifting or jump- 
ing, or falling from a height and striking on the feet. 

The nature of the displacement involves the condi- 
tion of other organs, and the symptoms necessarily 
depend in a measure on the character and degree of 
displacement. 

When the displacement is downward, (prolapsus) 
which is the form most frequently observed, there is 
painful dragging and bearing down, sometimes so 



242 



PAINLESS CHILDBIRTH 



severe that it seems as if the whole of the contents 
of the pelvis would be forced outside of the body, 
backache, headache, pain in the limbs and perhaps 
swelling of the feet. The pressure on the rectum 
causes piles and constipation, and on the bladder, 
frequency or difficulty in urinating. A sinking and 
sense of goneness in the stomach and all the symp- 
toms that accompany the inflammatory troubles 
already described are usually present. 

When it is backward (retroversion), in addition to 
the symptoms of prolapsus which generally are present, 



Figure 25 



Figure 26 




Anteversion 



Retroversion 



the pain in the back is greater and often extends to 
the head, and the pressure on the rectum may be so 
great as to render an evacuation of the bowels almost 
impossible. An examination reveals the mouth of the 
uterus pointing toward or pressing against some part 



DISEASES OF WOMEN 



243 



of the bladder, and the body may be felt lying in the 
hollow of the sacrum. If the case is one of ante- version 
the body of the womb presses forward and downward 
upon the bladder, while the mouth is turned backward 
in the hollow of the sacrum. The bladder becomes very 
irritable and the suffering is often intense. 

Usually the symptoms are so plain that a diagnosis 
can be made from the statement of the patient, but 
there is a possibility of error. Tumors constitute the 
principal causes of mistake. 

In the flexions (anteflexion and retroflexion) in addi- 
tion to the foregoing symptoms, the neck of the womb 

Figure 27 Figure, 27a 




Anteflexion 



Retroflexion 



being bent on itself backward or forward as the case 
may be is likely to obstruct the canal and become an 
impediment to the exit of the menstrual discharge on 
the one hand or the ingress of spermatozoa on the 



244 PAINLESS CHILDBIRTH 

other, causing in the first instance dysmenorrhcea, in 
the other barrenness. 

Take the finger of a glove in your hand up to the 
middle and allow the hand to fall over and you have a 
fair idea of the operation of a uterine flexion. 

As I have already remarked, these displacements are 
usually directly or indirectly caused by inflammation 
in some form or other. If this pathological fact is borne 
In mind it will be of great value in understanding the 
treatment. 

As already stated, inflammation is the most potent 
cause of uterine displacement. Congestion operating 
in the same way is also a fruitful cause. They act as 
causes by increasing the weight of the uterus beyond 
the power of its supports to hold it in place. Anything 
that increases its weight predisposes it to displacement; 
violent exertion or even long continuance in the erect 
posture under such circumstances cause it to settle 
into displacement. When congested or inflamed, 
jumping, jolting, lifting, straining, dysentery, etc., etc., 
displace it. 

The sufferings caused by it can be appreciated only 
by those who have experienced it. In some the devia- 
tion has been gradually effected and they do not seem 
to suffer acutely; others are unable to walk or stand. 
When it has occurred suddenly, as a result of a strain 
or fall or lifting a heavy weight, the suffering is often 
described as acute. Very seldom, however, if ever, 
does it occur without causing more or less suffering 
and constitutional disturbance, and when it has once 
occurred it is very apt to recur. 

The inflammation extending to adjacent structures 
sometimes causes adhesions that securely fasten the 



DISEASES OF WOMEN 245 

organ in its false position and entail lifelong trouble. 
This one circumstance points out the importance of 
early efficient treatment. 

j There are few troubles that assail human beings the 
treatment of which have received more attention than 
this. Supporters without number have been devised. 
When they have been arrayed for examination it would 
almost seem as if the ingenuity of man had been ex- 
hausted. Every conceivable form and shape, from a 
ball to a horse shoe; from a simple cup to the most 
complicated receptacle; light and heavy, large and 
small; some easily adjusted, others that cannot be; 
indeed, a large majority of them seem to have been 
built without any regard whatever to the purpose the}^ 
were intended to serve. Many of them relieve one 
pain to cause another. It would take the whole book 
were I to attempt to describe them. Probably they will 
always be in demand; almost all physicians use them. 
Indeed, it is fashionable. No physician wants to show 
his ignorance by admitting he doesn't understand one 
or know how to apply it. Of course, anyone can apply 
one, even if it is adjusted wrong side up! 

There is a principle involved in the cure of these 
troubles that it will be well to remember. The effect 
of inflammation and congestion is to increase the size 
and weight of the womb so that it is disposed to fall 
from its natural position by its own gravity when its 
supports have become weakened. A supporter may 
elevate it to its natural position, but it does not over- 
come the increased density nor strengthen the supports. 
If properly adjusted the supporter may afford relief, 
but not cure. At best they are but an auxiliary, and 



246 PAINLESS CHILDBIRTH 

those who rely on them as curatives can but meet 
with disappointment. 

The indications then are to arrest the inflammation, 
remove the extra weight occasioned by it and strengthen 
its supports. Were I writing this chapter especially 
for the profession I should consider the physiological 
and pathological conditions involved more at length; 
as it is, probably it is unnecessary. 

We will frequently find cases where the inflammation 
has subsided and its consequences alone remain; again, 
the inflammation continues. In either case we must 
adapt the treatment to the needs of the individual. 

Replace the womb and if there is inflammation 
proceed as advised under that head, using the cotton 
tampons properly applied instead of a supporter. Medi- 
cate it if necessary. The cotton will not cause the pain 
a hard instrument will, while it can be made a medi- 
cated appliance to cure the inflammation instead of 
increasing it, as is sometimes the case with solid sup- 
porters. 

By adapting the size, shape and position of the cotton 
supporters the uterus can be maintained in position. 

When the inflammation does not require special 
medicines for its control, alteratives to overcome the 
adventitious deposits that increase its weight are to 
be administered. Take: 

Fluid Extract Corydalis, . . 1 ounce 

Fluid Extract Ergot, . . 1 ounce 

Fluid Extract Black Cohosh, . % ounce 
Nitrate Potash, H ounce 

Simple Elixir, . . to make 8 ounces 

Mix. Give a teaspoonful three times a day. 



DISEASES OF WOMEN 247 

Overcome the muscular weakness of the uterine 
supports by tonics, exercise, etc., thus: 

Fluid Extract Nux Vomica, . K dram 

Fluid Extract Golden Seal, . 2 drams 

Elixir, to make 4 ounces 

Dose — A teaspoonful at meals. 

The existence of other symptoms that demand at- 
tention may require that other agents be added to 
these prescriptions to fulfill the special indications. 

Cold sitz baths, hot vaginal douches, regular bowels, 
thorough rubbing, are advisable. Exercise that brings 
the relaxed muscles into play and develops their strength 
should be employed; carefully at first, increasing as it 
will answer. 

We must remember that the contents of the abdomen 
are disposed to press the contents of the pelvis down- 
ward and thus interfere with the cure of displacement. 
Many females of a lax muscular habit are thus affected 
to a great extent and should be aided by an external 
band or support, as it will afford relief from many dis- 
tressing symptoms. They should, however, remove 
this artificial support at stated intervals and take such 
exercise as will bring the muscles involved into action 
and thus develop them. Nearly any treatise on calis- 
thenics will give the information needed on these points. 

Any muscle that has its function suspended for any 
considerable length of time becomes weakened and 
attenuated; hence, I say supporters cannot cure their 
debility and I wish to avoid them. A great deal of 
discretion, however, is needed to determine when and 
to what extent supports should be used. No absolute 
rule can be laid down. We must be governed by the 
circumstances and conditions present. 



248 PAINLESS CHILDBIRTH 

Tonic and astringent medicaments are required as 
applications with the cotton tampons and injections 
during the time to overcome the relaxation of the pelvic 
tissues, and the pinus canadensis, the golden seal, 
witch hazel, etc., may be used as already suggested 
in the treatment of chronic inflammation, after the 
inflammatory symptoms have yielded. 

Much care will be needed to adjust the tampons 
properly to secure the greatest benefit from their use. 
They should be changed daily. 

To replace a displaced uterus is not always as easy 
as may be supposed, and many who have tried it and 
been disappointed in the success of their efforts will 
often regard themselves as unequal to the task. If 
there are no adhesions binding it firmly in its mal- 
position it can be easily accomplished. 

First remove the weight of the abdominal viscera; 
take advantage of the law of gravity, secure the aid 
of atmospheric pressure if needed and accomplish the 
rest by manipulation. The first and second steps are 
accomplished by the knee-chest position. Let the 
patient kneel upon a table or some unyielding surface — 
lounge, sofa or even the floor — then bending the body 
forward until the chest and abdomen lie upon the table, 
tilt the body slightly to the left so the left side of the 
face and shoulder are upon the table, the arm thrown 
behind her, the hips being kept elevated as high as 
the length of the limbs from the knee to the hip will 
admit. 

This position relaxes the abdominal muscles and the 
contents of the abdomen gravitate toward the chest, 
entirely removing their previous weight from the pel- 
vis. The contents of the pelvis are now at liberty to 



DISEASES OF WOMEN 249 

gravitate toward the abdomen and in some cases will 
do so without any help, resuming their natural position. 
If now an effort is made by manipulation to replace 
the uterus, the air fills the vagina and by its pressure 
crowds the pelvic organs towards the abdomen. In 
simple prolapsus or downward displacement this will 
usually be sufficient, but if there are adhesions, of 
course, no change will be effected. 

Sometimes when the case is one of retroversion the 
uterus is wedged into the hollow of the sacrum so 
securely that manipulation will be necessary, and the 
operator will often be surprised to find the uterus sud- 
denly leave his fingers and resume its normal position, 
even in cases where all previous efforts had been un- 
availing. 

If an unprofessional person cannot effect a replace- 
ment by this method there is little use of trying further. 

If now a supporter has been selected it should be 
adjusted at once, otherwise the cotton tampon should 
be inserted before the woman changes her position 
and while the womb is in its natural position, or perhaps 
a little higher up than natural, after which let her lie 
down and rest a little while before she makes an at- 
tempt to get upon her feet. 

In chronic cases there will be a disposition to get 
out of place, but the woman has it in her power to 
relieve herself at any time when she finds herself in 
agony from a sudden displacement if she will but make 
endeavor as above described. 

This plan may have to be repeated in long-standing 
cases many times, and at the same time there should 
be a constant endeavor to invigorate the whole system, 
to renew the supporting power of the attachments so 



250 PAINLESS CHILDBIRTH 

that they can hold the organ in its proper position 
without the aid of any artificial devices. Instrumental 
supports seek to hold the organ in its place independent 
of change in the condition of the organ itself or im- 
provement of its muscular attachments. They do not 
cure but substitute. 

By the plan I have just described, to the originality 
of which I make no claim, we seek to make a perma- 
nent cure, using mechanical aid only as an adjunct 
and to temporarily effect what we endeavor by this 
and other means to make lasting. 

Although I have argued against artificial supporters 
(instrumental), I do not wish to be understood that 
they are useless; such a position would be extremely 
ridiculous in the face of their employment by some 
of the brightest lights of the profession. I am aware 
that there are cases in which there is nothing left but 
to use them, and it is certainly better to do so than to 
have the woman suffer. I, however, wish to avoid 
them when possible. I wish to cure instead of simply 
relieve and am confident that properly managed cases 
can be cured by the foregoing plan in which the artifi- 
cial treatment has previously failed. Should medicines, 
position and pessaries fail to cure the case a surgical 
operation to shorten the ligaments or even remove the 
womb may be needed. 

SUB-INVOLUTION 

During gestation, to accommodate the development 
of the foetus, the uterus is necessarily increased in size. 
The walls do not become thicker, but more extensive. 
The return to its former size after delivery is termed 
involution. If this process is arrested before it is com- 
plete, the uterus is left in a state termed sub-involution. 



DISEASES OF WOMEN 251 

The cause of this arrest is generally inflammation, 
the degree of which is various. It may or may not be 
attended with febrile symptoms, the contractions are 
feeble and inefficient, the muscular wall loses its power 
to effect the shrinkage necessary. While this condition 
lasts there is danger from hemorrhage. As time wears 
on and the acute are succeeded by chronic symptoms 
the danger of sudden hemorrhage may subside; but 
there remains more or less disturbance of the uterine 
function, liability to displacement, etc. 

Women are often heard to say they have never 
been right since their baby was born. In many of such 
cases the process of involution has doubtless been 
arrested before completion. The best time to correct 
this is when it occurs. If the womb remains large and 
flabby, if hemorrhage continues, with pain, weight, heat 
in the lower abdomen and pelvis, it should receive at- 
tention. 

If the inflammatory symptoms run high, use aconite 
or veratrum or Pulsatilla in small and frequently re- 
peated doses, say fifteen drops of either, or each, in a 
glass two thirds full of water and take a teaspoonful 
every hour or two. Alternate this with : 

Fluid Extract Ergot, . . J^ ounce 

Fluid Extract Black Cohosh, . \i ounce 

Water, ..... 2 ounces 
Dose — A teaspoonful every four hours. 

After the case has become chronic (and they are 
met with months or years after the delivery), a course 
of treatment must be instituted to remove adventitious 
deposits and restore the natural functions of the womb 
and ovaries, together with such local applications as 



252 PAINLESS CHILDBIRTH 

shall excite a new and more vigorous activity in the 

absorbents of these parts. Take: 

Fluid Extract Corydalis, . . 1 ounce 

Fluid Extract Phytolacca, . . J^ ounce 

Fluid Extract Pipsissewa, . . 3^ ounce 

Simple Syrup or Elixir, . . 2 ounces 

Dose — A teaspoonful three or four times a day. 

If there is a disposition to hemorrhage or profuse 
menstruation, substitute an equal quantity of fluid ex- 
tract of beth root (trillium) for the Phytolacca (poke 
root). If there is anemia, give tonics, some of the 
formula already given will answer. Local applications 
are valuable. Iodine may be used either applied to 
the womb directly and followed by the glycerine and 
cotton tampon or it may be applied mixed in the glyc- 
erine as advised in chronic inflammation. An external 
supporter made to fit evenly and moderately compress 
the abdomen will be found useful. 

Out-door exercise to invigorate, bathing, etc., should 
be thoroughly carried out. The bowels should be kept 
regular and hot vaginal douches morning and night. 

Usually these cases require great perseverance. 

UTERINE TUMORS 

All organized growths that occur within the uterine 
walls or are attached to any of its surfaces are properly 
called tumors. Several varieties exist — polypus, fibroid, 
fibro-cellular, vesicular, cellular or mucus, vascular 
and encysted. They are variously distinguished by 
position and relation to the different parts of the uterus. 

Polypi are pendulous growths attached to some por- 
tion of the uterine mucous membrane by a narrow 
neck, varying in density and causing a variety of symp- 
toms that depend to a considerable extent upon the 
seat of their attachment. When located within the 



DISEASES OF WOMEN 



253 



cavity of the uterus they are apt to derange men- 
struation, rendering it profuse, causing weakness, 
anemia, leucorrhoea, dragging pain; being out of 
reach they may not be detected for months and years. 
The neck may become elongated and the body be 
expelled outside the uterus where it hangs till removed 
by surgical means. They may occur in the canal and 
obstruct the menstrual flow, causing great pain and 
making the flow exceedingly profuse. In such position 
they can cause absolute sterility. They may be at- 
tached to the mouth of the uterus within easy reach. 
Their only treatment is removal by surgical means. 




Figure 28 

Fibroid tumors are by far the most frequent, diffi- 
cult to manage and dangerous. They may occupy any 
part of the uterine substance, but are oftenest found 
in the posterior wall, (Fig. 28) and are generally round 
or oval in shape. The size varies very considerably. 



254 PAINLESS CHILDBIRTH 

Increasing the size and weight of the uterus, they 
cause displacement. 

The great danger is from hemorrhage, which does 
not by smy means bear a definite relation to the size 
of the tumor. The menstrual function is deranged, 
often with great pain and profuse flow, and the pressure 
of the tumor on the pelvic nerves frequently causes 
neuralgic pain and numbness. Constipation and 
irritability of bladder may occur. Sterility is likely to 
result, or if conception takes place abortion will be 
very likely to follow. 

The diagnosis is not easy. Recurring hemorrhage 
causes suspicion of their presence, particularly if there 
be existing displacement. Careful manipulation is 
necessary, and the use of the sound will be required 
before a diagnosis is certain. Skill is needed to make 
certain the existence of the tumor, its location, etc. 

The treatment of these affections is very difficult. 
To control hemorrhage is one of the first things to be 
considered. If we cannot cure we can prolong life. 
The removal of the tumor is the only way to effect a 
permanent cure. This is often very troublesome and 
in some cases impossible. A knowledge of the character, 
location and attachments of the growth are necessary 
before we can form an opinion of the success of the 
treatment or the plan to be pursued. 

To arrest the hemorrhage, boldness and energy are 
often required. Give ten-grain doses of gallic acid 
in water and repeat every half hour; twenty drops of 
the oil of erigeron on sugar repeated every half hour; a 
strong tea of cinnamon, hemlock and witch hazel barks, 
given quite freely and often repeated; if the struc- 
ture of the womb is soft, lax and flabby, teaspoonful 



DISEASES OF WOMEN 255 

doses of the fluid extract of ergot repeated as often 
as necessary from twenty minutes to four hours are 
among the most prompt and convenient remedies. 
Keep the patient in a recumbent position, in a cool 
room, allow nothing but cold drinks, lower the head 
and elevate the pelvis. 

Local measures must not be overlooked. When 
there is much leucorrhoea or bloody discharge, antisep- 
tic vaginal douches should be used. A firm vaginal 
packing of antiseptic gauze or cotton, changed every 
day or two as necessary, will often prove an excellent 
means of controlling the bleeding for the time being. 
Astringent injections may be used; fill the vagina 
with cloths or cotton steeped in some astringent — 
alum or vinegar if nothing else is at hand. Be 
thorough, a life may be sacrificed by delay. Apply ice to 
the pelvis. A gum-elastic air bag, if at hand, may be 
introduced and inflated, completely plugging the pas- 
sage and preventing the escape of the blood. Some of 
these means can always be employed while waiting for 
remedies administered internally to take effect. 

Various plans have been advocated for the removal 
of these growths. If it is polypoid and in reach its 
removal may be effected by grasping with forceps and 
twisting its neck from its attachment, and dressing 
with astringents. 

If the growth is of a mushroom character, growing 
from the mucous membrane, in which case bits like 
" proud flesh" may be expelled occasionally, the womb 
must be dilated and removal effected by instruments 
adapted to the purpose. 

Fibroid and other tumors require surgical treatment. 
Electrolysis has been successful in some cases. The 



256 



PAINLESS CHILDBIRTH 



injection of iodine and other substances into the tumor 
with an instrument invented for this special purpose 
has been employed. Various other means have been 
resorted to, but as all forms of them are attended with 
great difficulty and require patience and skill I need 
not detail their modus operandi here, as it is not ex- 
pected their removal will be attempted by other than 
competent physicians. 

Such various means as have already been recom- 
mended to build up and strengthen are always in order, 
among which acids are most appropriate, as they coun- 
teract the hemorrhagic tendency, to some extent. 

CANCER 

A consideration of this disease is of too much gravity 
to enter into a work intended for public guidance. The 
disease must be dealt with promptly and thoroughly, 




Figure 29 



DISEASES OF WOMEN 257 

if at all, and no one should tamper with it unless quali- 
fied by clinical experience and armed with the necessary 
means to carry out whatever procedure is determined 
upon. 

Cancer of the womb occurs most frequently between 
the ages of forty and fifty. Frequent child bearing and 
tears or lacerations of the neck of the womb seem to 
predispose to cancer. 

A consideration of the symptoms may, however, be 
appropriate, as they may induce some of the afflicted 
to seek proper relief before it is too late. 

Hemorrhage is usually the first symptom. The oc- 
currence of hemorrhage in a woman who has passed 
the change of life should always arouse suspicion of 
cancer. Discharges, pain and fetor are the symptoms 
that most generally attract attention; and when these 
three are present the case is most generally an advanced 
one. The pain is characteristic — lancinating, darting, 
twinging. The discharge consists of blood, limpid 
serum, minute sloughs. The blood and serum do not 
cause the fetor; it is the disintegration of the sloughs- 
cancer cells. In women who are still menstruating, the 
first discharge is the blood, then an increase of the 
menstrual flow, then blood between times — all from 
the mucus membrane of the uterus. 

Later, however, when the hemorrhage is constant 
and is attended with fetor it is effused from the eroded 
vessels upon the ulcerated surface — in the one case 
the result of turgessence, in the other disintegration 
of tissue. Limpid, inoffensive serum is almost always 
observed, after the menstrual period, in women about 
the change of life, and very gradually this transparent 



258 PAINLESS CHILDBIRTH 

liquid becomes colored with blood; after a while it 
becomes fetid, etc. 

Lancinating pain, sero-sanguineous discharge, pe- 
culiar fetor, persistently continuing for days and weeks, 
are distinctive of cancer. With these we have the 
peculiar constitutional condition known as the cancer- 
ous cachexia. Cancerous an2emia,with the straw-colored 
translucency of the skin known as the cancerous 
cachexia, with the impairment and failure of function 
in a long struggle with pain, loss of blood, anxiety 
and inaction, together with debility, indigestion, palpi- 
tation, restlessness, neuralgia, constipation in the early 
stages and colliquative diarrhoea in the latter, apthse, 
night sweats, wandering of the mind, together with 
pain and exhausting discharges, are the destroying 
agencies. 

As already stated, I will not advise as to treatment. 
I know of no specifics or anything approaching to them, 
but, do what you may, I beg of you to steer clear of 
cancer quacks and incompetent physicians. 

CHANGE OF LIFE 

After years of menstrual activity the woman under- 
goes another change and she ceases to menstruate. 
The age at which this occurs varies greatly. Forty- 
five is considered the average, but numerous cases 
occur in which it is continued for several years later. 
The cessation of this function is often attended with 
phenomena that demand attention, and while it often 
terminates the existence of previous illness it may also 
be the commencement of various afflictions. 

In some parts of the country there is a sort of prov- 
erb that women who have previously been weakly 
become healthy and robust, while those who had before 



DISEASES OF WOMEN 259 

been healthy and strong now become sickly. While 
in some the climateric change does not occasion any 
symptoms requiring attention, in others serious conse- 
quences develop that tax the skill and tact of the 
physician. Too often these phenomena are passed 
without attention or the symptoms are referred to as 
the "turn of life" and the woman told she must wait 
until this period has passed before she can expect to 
be better. Not only does this refer to the sympathetic 
phenomena arising from the arrest of a physiological 
function, but to pathological conditions that develop 
independently of it. 

The suffering endured at this time is too often re- 
garded as a sort of necessary affliction and is passed 
as a "must be," while the truth is, nothing is farther 
from right, for the more attention we give to the 
modification of symptoms, the arrest of disease and the 
preservation of the health at this time the greater will 
be the chances for the enjoyment of perfect health 
afterwards. 

From fifteen to forty-five, sooner or later, according to the 
peculiar vivacity and vital stamina of the patient, she has men- 
struated regularly, and now the germ production has gone forever. 
There is no longer the monthly periods; the ovaries have ceased 
to produce germs; but, though this has happened, the affections 
of the soul have but matured; her power to love remains in full 
force and ardor, and also the desire and capacity for sexual en- 
joyment. Some women continue beautiful and attractive until 
they are seventy. The cessation of the menses at this period is 
a wise provision of nature, for if women went on producing off- 
spring till a ripe old age the resurc would be a puny race. The 
generative power disappears as she passes the period of maturity, 
and women who have borne children have a compensation for 
their privations and cares. — Buchanan. 



260 PAINLESS CHILDBIRTH 

This period is ushered in in various ways. Men- 
struation seldom ceases all at once unless some acci- 
dent occurs by which it is arrested. It usually becomes 
more or less irregular. It may recur too frequently 
or it may be delayed several weeks or even months 
and then return too profusely — perhaps be regular a 
few times and then cease altogether. There is usually 
lassitude, debility, headache, nervousness, aching in 
the back and limbs, flashes of heat, deranged secre- 
tions, dyspepsia, etc. 

Temperament modifies symptoms materially, but 
hot flashes are present in nearly all cases. Plethora 
or anemia develops. The blood itself, no doubt, under- 
goes some change, a host of symptoms are present. 
She becomes fanciful, even hysterical; she imagines 
everything ails her, and this morbid imagination^ often 
leads to her neglect. That class of symptoms termed 
"nervous" prevails, producing an endless variety of 
phenomena, distressing to the patient and annoying to 
her family. Mental aberration often occurs. The 
patient suffers both mentally and physically. 

The treatment for obvious reasons must be consid- 
erably varied. A wide range of conditions may be 
developed each of which may require to be met and 
subdued. Whatever function is deranged, whatever 
organ suffers, should receive attention. The hygienic 
measures already advised for various ills will contrib- 
ute more or less to the establishment of a healthful 
condition. 

Plethoric women suffer from rush of blood to the 
head, vertigo and frequent attacks of hemorrhage. 
They make blood too fast. They need spare diet, 



DISEASES OF WOMEN 261 

exercise and, if the bowels are sluggish, saline cathar- 
tics, they bear purges well; then if the circulation is 
excited give veratrum, a drop of the fluid extract in 
water every hour or two. Such cases generally derive 
much benefit from bromide of potash in infusion of 
squaw vine; ten grains of the bromide in an ounce of 
the infusion three or four times a day is good treatment. 

If anemia prevails, the blood gets impoverished, is 
thin and watery, is not manufactured fast enough to 
supply the waste, there will be headache, etc., etc., 
we must give tonics and nervines, and avoid excite- 
ment. An infusion of the squaw vine and ladies' 
slipper in tablespoonful doses three or four times a 
day is excellent; alternate with a good iron tonic. 

If the bowels are irregular, the remedies already 
mentioned may be employed. 

Displacements are often annoying, with all the rest. 

The kidneys and skin most be kept active. 

Dr. Dye's Mitchella Compound probably fills as 
many or more indications than any other remedy and 
suits nearly all cases. The range of probabilities being 
so great and complications so numerous my space 
will only admit of generalizing the treatment. Should 
cases arise that do not yield to these remedies I will 
advise more specifically. Yet if these directions are 
followed such necessity will seldom occur. 

UTERINE STRICTURE 

As a result of inflammatory disease, non-develop- 
ment or the improper use of caustic applications, the 
canal leading to the cavity of the uterus is sometimes 
narrowed to such an extent that it may cause the most 
terrible dysmenorrhoea on the one hand or absolute 
sterility on the other; the passage being too small to 



262 PAINLESS CHILDBIRTH 

allow the exit of the menstrual discharge or admit the 
sperm cells. 

The consequences of this condition have already 
been alluded to in the consideration of sterility and 
mechanical dysmenorrhcea, and operate by closing the 
canal, though differently from flexion and polypi. The 
symptoms are very similar to those tioubles, but can 
only be determined from them by a careful exploration. 

The treatment consists in dilating the passage or 
in dividing the stricture. 

Dilation usually succeeds temporarily, but is not 
apt to give permanent results, owing to the disposi- 
tion of the stricture to contract again. Division when 
skillfully performed is more permanent. The operation 
is effected with instruments for the purpose, but re- 
quires great care after its performance to render it 
successful. If the incised surfaces are allowed to come 
in contact they are very apt to unite and render the 
trouble worse than before. The operation itself is 
accompanied with little danger, but must be attended 
to daily for some time or failure results. It should never 
be undertaken by anyone other than a qualified physi- 
cian provided with all the necesary facilities for effectu- 
ally executing all the various steps of the operation 
and the subsequent treatment. 

VAGINISMUS 

Professor Sims applied this name to a spasmodic 
sensitiveness of the vagina. It occasions in many 
cases the most intense agony when anything is brought 
in contact with it. The existence of such an impedi- 
ment to the consummation of marriage often gives 
rise, and many times unjustly, to domestic unhappi- 
ness, jealousy, divorce or suicide. There is nothing 



DISEASES OF WOMEN 263 

more certain than that the woman afflicted with it 
suffers exceedingly. It may exist in the unmarried or 
be developed after marriage. It is usually due to 
inflammation of the vagina, self abuse or to sexual 
debauchery. Tilt says: 

I have seldom known this state to exist except as a symptom 
of vaginitis or of chronic metritis; and, like Scanzoni, by treat- 
ing these complaints I have been able to cure spasmodic stricture 
of the vagina. There is no doubt in my mind that in some of 
these cases the man is more at fault than his mate. 

A complete discussion of the subject, however, is 
scarcely appropriate in a work of this kind. I will, 
however, on application by the afflicted, explain the 
matter more fully and advise as the case presenting 
may demand. 

Tilt, Sims, Hood and many others have resorted to 
forcible instrumental dilatation to overcome the trouble, 
applying it under anesthesia. 

The first step seems to be to ascertain if there be 
inflammation present and if so, cure it, when the morbid 
sensitiveness will usually yield. There is no need of 
the suffering experienced from such cases, for it will 
yield to proper treatment; but for the reasons men- 
tioned above I will refrain from further discussion of 
the subject. 

THE OVARIES 

Situated in the cavity of the pelvis at either side 
of the uterus, communicating with it through the 
fallopian tubes, are two small organs, analogous to the 
testes in the male, called the ovaries. In them the germ 
cells are developed and when matured are passed 
through the fallopian tubes to the uterus and unless 
arrested there are expelled. The completion of this 



264 PAINLESS CHILDBIRTH 

process occasions the phenomena of menstruation. If, 
however, the sperm cells of the male come in contact 
with the germ cell under favorable circumstances during 
some part of the passage from the ovary to the womb 
conception occurs. 

It is truly wonderful the influence these little organs 
exert upon the life and happiness of woman. An author 
in endeavoring to illustrate their importance has said: 

It would seem as if the Almighty had taken two ovaries and 
built up a human being around them. 

These organs are liable to congestion, inflammation, 
neuralgia, enlargement, displacement, or may be the 
seat of tumors that grow to enormous size. They are 
influenced by colds, self-abuse, sexual excesses, uterine 
disease and displacements. 

Either as a cause or effect, the ovaries in women 
who suffer from derangement of menstruation become 
swollen, painful and tender. They can often be felt 
when swollen, except the woman be fleshy, through 
the walls of the abdomen, inside and just below the 
points of the hips. 

The congestion often gives rise to the most intense 
pain, not infrequently causing spasms, hysterical phe- 
nomena, etc. Menstruation may be deranged and is 
apt to be profuse, the sufferer becomes weak, anemic, 
nervous, fretful. Sexual debauchery predisposes to 
these troubles and is often the cause of the most in- 
tense neuralgia. Women of nervous temperament are 
most subject to these affections. I have seen the most 
troublesome menstrual disorders occasioned by con- 
gested ovaries; the menses were profuse and recurred 
every two weeks, resisting all treatment until the cause 



DISEASES OF WOMEN 265 

was discovered and treatment addressed to its removal. 
Usually one ovary is affected, though both may be. 
The congestion may persist for a long time, being 
worse just before menstruation, disappearing after the 
flow has well begun, to reappear again at the next 
period. The location of the pain and soreness will 
usually be sufficient to indicate the trouble. 

Begin a week before the expected trouble and take 
a teaspoonful three times a day of the following: 

Tincture Belladonna, . . 5 drops 

Water, ..... 4 ounces 
Mix. At the period it may be taken every two hours. 

In the interval, measures to improve the general 
health and the avoidance of all sexual excitement; 
sitz baths, outdoor exercise and the following: 

Bromide of Ammonia, . . 4 drams 

Quinine, ..... 30 grains 

Tincture Cinchona Compound, . 1 ounce 

Syrup of Orange, ... 3 ounces 
Dose — A teaspoonful three times a day. 

In inflammation of the ovaries there will be fever 
ushered in with chills, pain in the ovarian pulse, rest- 
lessness and general symptoms of inflammation. 

Rest quietly in bed, keep bowels open with Epsom 
salts and apply mustard, followed by hot applications 
to the abdomen, and hot foot baths. Then give: 

Tincture of Aconite, . . 10 drops 

Tincture of Gelseminum, . . 30 drops 

Water, ..... 4 ounces 
Mix. Dose — A teaspoonful every two or three hours. 

If it occurs at the time when menstruation should 
appear, let an infusion of serpentaria or Virginia snake 
root as it is generally called be drank. It will usually 



266 PAINLESS CHILDBIRTH 

cause sweating. It may be combined with motherwort 
in a small quantity. At the same time alternate the 
fever mixture above mentioned with drop doses of 
Pulsatilla every two hours. 

If an abscess forms, the ovary should be removed 
without unnecessary delay. 

A consideration of ovarian tumors in a work of this 
kind could be of no use to the general reader and will 
be omitted. 

SMALL AND SHRUNKEN BREASTS 

Next to facial beauty does woman pride herself on 
a proper development of her breasts. If too large or 
too small they render her figure imperfect and materi- 
ally impair her attractiveness. 

Not only is perfection here essential to beauty and 
happiness, but it is also necessary for the perfect per- 
formance of that function to which all true women 
aspire — maternity. 

But, alas! these organs so doubly essential to the 
health, happiness and usefulness of women are prone 
to disease. They may be arrested in their develop- 
ment or, after having been developed, they may under- 
go retrograde metamorphosis and become shrunken, 
shrivelled, unsightly; development may proceed so far 
that they become too large and burdensome. They 
are often the seat of tumors, cancers, etc. Again, they 
are liable to inflammation and abscesses. 

Any departure from a natural size and firmness 
constitutes a disease, and may as appropriately be 
regarded so and subjected to proper treatment as any 
other organs that more intimately influence the proc- 
esses of life. 






DISEASES OF WOMEN 267 

The breasts are properly to be considered as a part 
of the reproductive system, and menstrual and uterine 
diseases are often manifested by diseases of the breasts. 
In fact, uterine disease is in a large proportion of cases 
manifested by wasting of the breasts. 

Atrophy or non-development of the breasts, like 
other diseases, admits of a cure, and women whose 
forms are imperfect and who habitually resort to arti- 
ficial means can have the defect overcome by a proper 
course of treatment. The cause must be considered 
and the relation of the wasting to the other diseases 
must be studied and such treatment devised as shall 
bring about the most perfect state of the general health, 
then remedies to increase the nutrition and cell develop- 
ment locally. will succeed in all cases. 

The matter has received much attention during the 
past few years, and several remedies have been found 
that exert an efficient curative influence over this 
condition. I will, however, omit explaining them, 
because were I to do so it would open a field for quacks 
to operate in, who would take advantage of woman's 
desires to be attractive and flood the country with 
nostrums that would necessarily disappoint as many 
or more than were gratified. There are no specifics. 
We must consider conditions present and apply the 
remedies in accordance with those physiological and 
therapeutic laws that govern scientific treatment in 
other diseases. Any woman wishing further informa- 
tion on this subject should write to Dr. Dye's Medical 
Institute without delay. 

CANCER OF BREAST 

The strong disposition of cancerous disease to locate 
in the female breast, necessarily causes alarm at the 



268 PAINLESS CHILDBIRTH 

discovery of any bunch or tumor in this locality. The 
diagnosis is not easy except when the disease is well 
advanced, and physicians often find it difficult to dis- 
tinguish between benign and malignant tumors. A 
few points, therefore, may not be amiss. The form 
of cancer found here is generally very hard and is 
frequently called stone cancer in common parlance, 
while in professional language it is scirrhus. It is very 
hard, knotty to the feel, there is darting, gnawing, 
lancinating pain, and when well advanced becomes 
immovable, the surface discolored, the nipple drawn 
backward into the mass, the glands in the armpit 
enlarge and the whole complexion gradually develops 
that peculiar waxy, sallow hue known as the cancerous 
cachexy. On the other hand, benign tumors do not 
present these characters, but may become much larger 
than a real cancer. 

The treatment is surgical — extirpation — and should 
be resorted to before the whole system is impregnated 
with cancer cells. If there is no pain or soreness, take 
time and do not be scared into doing what will do no 
good. If it presents the characteristics of cancer, early 
removal is advisable. 

The consideration of cancer, however, is not within 
the intention of this work, and though my space has 
necessitated the curtailment of many subjects it is the 
earnest hope of the author that the hints expressed 
will point many who are in search of health to the 
recovery of that desirable boon. 



CHAPTER XVII 



STERILITY 

In obedience to a Divine mandate it is natural for 
woman to yearn for motherhood, for it is the ideal 
state of every woman who has not already arrived 
there. Although it is not uncommon to meet young 
married women who wish to defer the assumption of 
maternal responsibilities for a time, there are few women 
indeed who will voluntarily pursue life's journey with- 
out the companionship of one or more of those little 
blessings to enliven her sympathies and increase her 
enjoyment in the noonday of life and to comfort her 
declining years. 

Marriage is the consummation of love; yet without 
offspring its object is but half attained. The coming 
of children strengthens the ties already existing between 
man and wife and renders happy and harmonious lives 
that would otherwise be passed in estrangement and 
discord. 

The yearning of the wife's heart for children is a 
natural instinct that is largely shared by the husband. 
Although they may conceal their desires from one 
another, and even publicly assert that they entertain 
an intense hatred for children, in the privacy of the 



270 PAINLESS CHILDBIRTH 

professional consultation confessions are made which 
prove that nature is true to herself. 

With many females the grave is looked forward to with more 
cheerfulness than a childless longevity, and not a few husbands 
would rather die in the prime of manhood and leave an heir 
than to live to gray old age and be considered incapable of 
reproduction. 

So great is the regard of offspring by both husband 
and wife (and I do not consider it a betrayal of pro- 
fessional confidence when I assert that I am very often 
consulted on the subject either in person or by letter), 
the question is often asked by both male and female, 
"Am I capable of becoming a parent?" and when 
disappointed in the realization of their desires, though 
perhaps charging the fault upon the other, they se- 
cretly and without the knowledge of the other seek 
professional advice and remedy. In other cases both 
parties seek advice together, hoping by so doing that 
the true cause of the barrenness may be ascertained 
and the proper remedy obtained. 

There are very few subjects that give men or women 
more anxiety than this, for to go through life with the 
self-consciousness of procreative inability is indeed a 
source of very great unhappiness. Quacks have taken 
advantage of this and made the subject the basis of 
numerous " Marriage Guides," in which the authors 
have sought to impress the unmarried with a belief 
in their own incompetency in order to wring from them 
large sums of money for pretended restoration. 

According to the observations made by English 
investigators nearly one married woman in eight is 
barren. Barrenness, however, cannot be considered as 
absolute, even without interference, for it is known that 



STERILITY 271 

women who have borne children may become sterile, 
while on the other hand women who have been sterile 
for years subsequently become fertile. It has not, 
however, transpired in the course of these investi- 
gations how far the sterility may be the fault of the 
husband. Nor is it likely that such an inquiry can 
ever receive more than an approximate answer, for the 
very reason that people will never consent to have 
their private matters become public property to the 
extent necessary to form a close estimate, based upon 
statistics. 

Having made chronic diseases of the reproductive 
functions of both sexes a specialty for years I trust I 
may be pardoned for saying that the subject of pro- 
creation concerns gentlemen far more than is generally 
supposed. 

In connection with the subject of sterility it may 
not be any breach of professional confidence when I 
say that the extensive prevalence of sexual abuses and 
excesses of the young, and even of the middle-aged, 
render them liable to certain disorders which so inti- 
mately concern the married state that I am consulted 
daily either in person or by letter by both sexes as to 
the propriety of marriage. I mention the matter here 
to illustrate the causes of sterility as being sometimes 
the husband's fault, for which the wife is generally 
blamed. If the male party to a marriage contract has 
by vices and pernicious practices despoiled his manhood 
and finds the union unhappy or unproductive in conse- 
quence, it is fully as proper that he seek professional 
assistance as for the wife to bear the odium of barren- 
ness. Happily, I am able to offer those who consult 
me in these matters very decided assistance, these 



272 PAINLESS CHILDBIRTH 

disabilities being for the most part amenable to proper 
treatment. 

The average time elapsing between marriage and 
the first child is about seventeen months. The first 
three years may be permitted to lapse before the woman 
can practically consider herself sterile, though if she has 
not made use of any preventive during that length of 
time and conception has not occurred the chances are 
as thirteen to one against her, for she will be likely to 
remain unfruitful except she receive assistance from art. 

In considering this subject it is to be remembered 
that it does not always follow because a marriage is 
fruitless the wife is to blame; nor does it follow because 
a woman has not borne living children that she is always 
sterile; not is it certain that if she is barren the first 
few years of married life that she will never have 
children. Women sometimes become fecund after years 
of sterility. The mother of Louis XIV was sterile for 
twenty-two years before his birth; the wife of Henry 
II became the mother of ten children after a period 
of ten years of barrenness. Dr. Tilt, of England, men- 
tions a case of a healthy woman who had married a 
healthy man at eighteen, but did not bear a child until 
she was forty-eight. Numerous instances are on record 
where a marriage has been unproductive, divorce 
followed with subsequent marriage of the man and 
wife to another woman and man, respectively, and 
the subsequent unions were blessed with offspring. 

The causes of sterility are various, and in a very large 
per cent of cases can be remedied. A careful investi- 
gation of each individual case will usually reveal the 
cause of sterility, so that I can point out the indica- 
tions of cure. 



STERILITY 273 

Among the causes most frequently met are the 
following: 

Chronic inflammation of the neck or body of the 
womb, stricture of the neck of the womb, flexure or 
elongation of the neck of the womb, tumors, growths, 
polypi or other obstructions of the neck of the womb, 
displacements, uterine tumors, ovarian diseases, pro- 
fuse and acrid vaginal secretions, uterine catarrh, 
leucorrhoea, imperforate hymen, sexual excesses, uter- 
ine and ovarian debility, membraneous dysmenorrhoea, 
menstrual derangements, sexual frigidity, nursing, late 
marriages, disease of husband causing imperfect devel- 
opment of spermatozoa, temperamental incompati- 
bility, imperfect development of the womb and ovaries, 
displacement of the ovaries, stricture of the fallopian 
tubes, adhesion of the fimbriated extremity of the 
fallopian tubes, etc., etc. 

From this list of causes it will be readily inferred 
that with the exception of the last three or four, all 
are amenable to treatment when properly understood, 
because they are dependent upon conditions which 
the best authorities of the present unite in declaring 
curable. 

Formerly, the causes of sterility were shrouded in 
mystery, and the treatment speculative and empirical, 
but light has been let in upon the subject by modern 
investigators, and barrenness is now known to be occa- 
sioned by certain conditions capable of removal. Much 
of what is known of the diagnosis and treatment is 
due to the labors of Drs. Sims, Thomas, Emmet and 
a few others who have stripped the subject of its mys- 
tery and made the treatment more than a mere matter 
of conjecture and guesswork. 



274 PAINLESS CHILDBIRTH 

It will be seen that a very large per cent of these 
causes act in a purely mechanical manner by prevent- 
ing the entrance of the spermatozoa into the womb or 
beyond it, where it may by uniting with the germ cell 
occasion conception. Numerous theories have been 
advanced as to the manner in which conception takes 
place. 

It is now understood that the sperm cell of the male 
and the germ of the female must come in contact before 
it can occur, and that this union must occur beyond the 
mouth of the uterus and under certain conditions. 
How these cells influence each other is not at present 
definitely known, but upon their union the germ ac- 
quires a disposition to unite itself to some tissue from 
which it may receive nourishment and support. The 
tissue which is most favorable for this purpose is the 
lining of the cavity of the womb, though it sometimes 
occurs in the fallopian tubes or at the ovary. 

The cavity of the uterus appears to be the most 
favorably designed for the reception, protection and 
development of the fecundated germ, and the question 
seems settled that the sperm cell — the spermatozoon — 
must penetrate the reproductive passages of the female 
as far as this cavity, or fecundation cannot take place. 
So far as I have been able to ascertain no instances are 
recorded where conception has taken place between the 
cavity of the uterus and the external generative organs. 

So far as the penetration of spermatozoa to the cavity 
of the uterus is concerned it is entirely mechanical 
and may occur without the female experiencing any 
of the sensations due to the generative act whatever, 
although recent developments show beyond a doubt, 
such experience on her part favors such penetration. 



STERILITY 275 

Instances have been known in which the spermatozoa 
have penetrated the uterine cavity and passed through 
the fallopian tubes to the ovary, but it is not satisfac- 
torily determined that it must always be so in order 
that conception occur. After the union of these two 
infinitesimal cells has taken place, certain other favor- 
able conditions are necessary to their development, 
and it is upon these conditions that the success of the 
impregnation depends. If the sperm cells are unhealthy 
or imperfectly developed, although the maternal parts 
are prepared for their reception, their death instead 
of their development will occur. If the interior of the 
womb is in an unhealthy condition the fecundated germ 
may be unable to effect its adhesion and consequently 
be thrown off. 

Recent authors claim that a catarrhal condition of 
the lining membrane of the womb is to a very great 
extent to blame for all the cases of sterility not due to 
mechanical obstruction. Chronic inflammation of the 
mucous membrane will always be associated with a 
catarrhal discharge. The membrane being bathed in 
a secretion of its own mucus, while it may not destroy 
the germs by any poisonous qualities, prevents their 
lodgement and nutrition, and thus effectually pre- 
vents conception. If the ovaries are diseased, the germ 
cells may not be able to maintain life and perform their 
part. Thus failure may be due to some defect in the 
sperm cell, in the germ cell or in the condition of the 
uterus. 

In addition, disciples of the electro-magnetic and 
the temperamental doctrines would have us believe 
that the failure may be due to defective magnetic 



276 PAINLESS CHILDBIRTH 

conditions, temperamental incompatibilities, etc., which 
perhaps even they themselves cannot clearly explain. 

Among the causes of sterility, doubtless the most 
important are those which oppose the entrance of the 
spermatozoa into the uterine cavity where conception 
can take place; these are anything that obstructs the 
uterine canal, and may exist before a child has been 
born, or may be acquired afterward; thus, imperforate 
hymen, displacements, tumors, polypi, granulations 
or other growths within the neck of the womb, angular 
curvature of the uterine neck, stricture of the same and 
chronic inflammation, to which might be added, tech- 
nically, occlusion of the mouth of the womb. 

Imperforate hymen, as anyone who will consult a 
work on anatomy will readily see, necessarily prevents 
the entrance of the spermatozoa; indeed, it does not 
permit them to even reach the mouth of the womb 
at all. At one time the hymen was considered as the 
test of virginity, but, thanks to the enlightenment of 
the present, it is no longer so. There are many ways 
in which this membrane may be ruptured without in 
the least compromising the virginity of the female. 
It may be ruptured by the use of a female syringe 
which every female who respects cleanliness will use, 
occasionally at least. It may be so fragile as to be 
ruptured by the menstrual flow and in other ways; 
while on the other hand it may be so powerfully devel- 
oped that all attempts at copulation will be futile. 
There may be a small orifice through which the menses 
may escape and through which it is possible the sperma- 
tozoa may enter, but not probable. When this is the 
case, nothing short of a surgical operation will suffice 
for its removal. 



STERILITY 277 

On the one hand the woman is blamed if this exceed- 
ingly uncertain test of chastity does not exist, and on 
the other she will be blamed for the sterility its exces- 
sive development occasions. In the first place, none 
but the ignorant, prejudiced and exacting will be dis- 
appointed if it does not exist. In the second, a profes- 
sional consultation will allay any unhappiness and 
anxiety. Let our readers bear in mind that in medical 
jurisprudence the presence of this membrane is not an 
absolute proof of chastity, nor does its absence prove 
immorality. 

Uterine displacements may occasion sterility. The 
manner in which they operate is either to turn the 
mouth of the uterus in such a direction that the sperma- 
tozoa cannot reach it, which might be the case in ante- 
version, a displacement in which the body of the uterus 
is tipped forward and downward and the neck and 
mouth carried upward and backward, the central at- 
tachment acting as a pivot upon which the uterus very 
nearly turns bottom upward by tipping forward. This 
condition is usually associated with more or less trouble 
with the bladder and is exceedingly difficult to cure, 
mechanical means being usually essential to success. 
In retroversion the uterus tips backward instead of 
forward, the body of the organ falling backward into 
the hollow of the sacrum, while its mouth is carried 
forward and upward behind the bladder, turning the 
mouth persistently away from the spermatozoa. By the 
pressure of the uterus in this condition upon the lower 
bowel, constipation and backache are occasioned. This 
form of displacement is more frequently met than 
anteversion. It may be cured by mechanical measures 
to overcome the mal-position and the employment of 



278 PAINLESS CHILDBIRTH 

remedial agents to so tone its supports that the natural 
position may be maintained. Very often this displace- 
ment is associated with an enlargement and increase 
in weight of the organ which must be overcome before 
a permanent cure can be expected. These mal-positions 
very often result in sterility. 

Another form of displacement known as prolapsus 
or falling of the womb is often a cause of barrenness. 
In such cases the mouth of the uterus often rests upon 
the floor of the pelvis and is buried in the soft tissues 
covering the perineum or vaginal walls which form as 
it were by the pressure a complete covering for the 
mouth of the womb, preventing the entrance of any- 
thing. To overcome this trouble has taxed the inge- 
nuity of the profession for years. In such cases there 
are a great variety of symptoms, sympathetic dis- 
turbance, etc. The indications of cure are to reduce 
the increased weight of the organ, replace it and, by 
increasing the power of its supports or otherwise, main- 
tain the proper position. This is often difficult to do 
and we often hear a physician saying, "If you could 
only have a child it would cure you. " The truth of 
it is, if they could only cure the patient she would be 
very apt to have a child. We cannot in the space 
allowed this subject consider the methods of cure, nor 
would many be likely to succeed without professional 
assistance. Artificial supporters are necessary in many 
cases, while in others they make the trouble worse 
and are so painful that no woman can wear them. 

Tumors, growths, etc., when occurring in the uter- 
ine neck, form a mechanical obstruction to the entrance 
of the spermatozoa and, as conception cannot occur 
in the vagina, they become efficient causes of sterility. 



STERILITY 279 

By blocking up the canal of the uterus they interfere 
with the escape of the menstrual flow, causing severe 
pain at the menstrual period and, by modifying this 
function, are often the cause of profuse hemorrhage. 
A careful examination is necessary in order to correctly 
diagnose the nature of the trouble. On the introduction 
of a speculum the trouble may be at once apparent 
or it may require the dilatation of the uterine mouth 
and neck before the source of trouble becomes visible. 
Very often the morbid growth will be so small as to 
escape notice, yet it is a very efficient source of trouble. 
The growths most frequently met with are granulations, 
or polypi, though tumors may be present. 

The measures to be employed for their removal 
necessarily vary with the nature of the growth, size, 
location, etc., etc. Granulations and small polypi will 
usually disappear with appropriate treatment, and large 
polypi may be removed by forceps, snare, ligature or 
scissors. Hemorrhage may be troublesome, but usually 
in the hands of one who understands his business there 
will be little trouble or pain in their removal. The 
removal of tumors may be effected with a knife, liga- 
ture, caustic, injection or electricity. No one but a 
skillful surgeon has any business to touch them. When 
either of these troubles has caused sterility, their 
removal will be likely to be followed by conception. 

It may be proper to place in this division another 
form of abnormal development that is sometimes met 
as a cause of barrenness. It is when the posterior lip 
of the uterine mouth is unnaturally long and folds over 
the entrance of the womb like a valve, forming an effec- 
tual barrier against the entrance of anything into the 



280 PAINLESS CHILDBIRTH 

womb, but is no impediment to the escape of the men- 
strual flow. Such a condition might pass entirely un- 
noticed because it would not be attended by any other 
troubles that would be likely to lead to its recognition, 
and unless the female came under examination to 
ascertain the cause of her sterility it would probably 
never be known, and even then unless the examiner 
was on his guard it might easily escape detection. This 
cause can be easily remedied by a surgical operation. 

Curvature of the neck of the womb is a fruitful cause 
of sterility and is a frequent source of painful men- 
struation. The body of the womb may be bent upon its 
neck in such a manner as to obstruct the canal suffi- 
ciently to prevent the entrance of spermatozoa or exit 
of menstrual matters in the same way that a finger 
of a glove may be bent as to prevent the passage of 
even water. The curvature may be so great that the 
axes of the neck and body of the womb will intersect 
at nearly right angles. Take a hollow tube and bend 
it upon itself to a right angle, or even an obtuse angle, 
and you have a good illustration. When the curvature 
is forward it is called " anteflexion"; if backward 
' ' retroflexion ? ' ; if sideways ' i Lateral-curvature ' ' . 
These deviations from normal position are often more 
easily recognized than cured. 

Several forms of treatment are in vogue, one of 
which is to cut or divide one side of the neck, before 
or behind according to the flexion, in order to establish 
a straight and free passage. When properly performed 
it is generally successful. It is not very painful, though 
there may be some hemorrhage. The subsequent treat- 
ment must be thorough, or the divided portions may 
unite and leave it worse than before. Another plan is 



STERILITY 281 

to dilate the neck of the womb and introduce an instru- 
ment that will hold it straight until the curvature is 
effectually overcome. Uterine supporters are also em- 
ployed, but the surgical treatment is by far the most 
successful, though the dislike many entertain for the 
knife will often lead to a trial of the other measures. 
Many cases are recorded in which the successful treat- 
ment of curvature by one or the other of these methods 
has been followed by a realization of the highest hopes — 
a child! 

Stricture causes sterility in a manner very similar 
to curvature, the uterine canal being narrowed by 
constriction so as to prevent the easy passage of the 
menses from within or spermatozoa from without. An 
examination by the touch or by speculum will often 
reveal nothing, but when an attempt is made to intro- 
duce a uterine sound, the trouble becomes apparent. 
This trouble is therefore very often overlooked and 
the sterility attributed to other causes. There is very 
little excuse, however, for overlooking this condition 
when a thorough investigation is being made. 

The treatment of this difficulty consists in perma- 
nently enlarging the canal, which may be done either 
by stretching or dilating it with steel dilators, /or by a 
single or double incision. The operation of dilating 
should be thorough, so that there may be no tendency 
to return to the previous condition. The incision, 
performed in much the same manner as for curvature 
and properly attended until the incised surface has 
healed up, is almost always successful and occasions 
little pain, though the woman must remain in bed a 
few days. There are few cases but that remain perma- 
nent if the operation has been made with the requisite 



282 PAINLESS CHILDBIRTH 

amount of skill. The performance of this operation 
and the frequency with which it has been followed by 
conception, as well as relief from the most intense 
sufferings at the menstrual period, reflects very great 
credit upon the name of Dr. J. Marion Sims. 

Elongation of the neck of the womb is also a source 
of barrenness and painful menstruation, and its suc- 
cessful amputation has been effected. When the neck 
is unusually long there is generally a corresponding 
narrowness, and the treatment is made for the purpose 
of enlarging the canal to facilitate the passage of the 
spermatozoa. It makes little difference, in the result, 
which of the operations, as for stricture, are made, if 
properly performed, but, of course, skill will be necessary 
and no one must attempt it without a clear under- 
standing and the requisite facilities. 

Occlusion, by which a complete closure of the neck 
of the womb is meant, may be due to congenital mal- 
formation, or to ulceration which in healing has resulted 
in uniting the edges in such a manner as to completely 
obliterate the canal. The improper use of caustics 
may also produce this result, and nothing can enter 
the uterus nor escape from its cavity. Such a condition 
will be far more likely to demand interference on ac- 
count of the trouble arising from the retention of the 
menstrual discharge than for the relief of sterility. 
The establishment of an artificial opening by surgical 
means is necessary and gives speedy relief. Such cases 
are rare. 

Chronic inflammation may be confined to the neck 
of the womb, to the body or to both, and may involve 
only the mucus membrane lining, or extend to deeper 
structures. It is a frequent affliction of civilized women. 



STERILITY 283 

and on account of its frequency becomes one of the 
fruitful causes of barrenness. An endless variety of 
symptoms accompany this ailment which are not only 
referred to the reproductive organs but, through, 
sympathy, may extend to every part of the body. This 
ailment is not an absolute preventive of conception, 
but it is not very probable that the woman that is 
afflicted with it will bear children. 

In this trouble the neck of the womb may be much 
larger than natural and the membrane very much re- 
laxed; but there will be formed in the neck a plug of 
thick, tenacious mucus so completely filling the canal 
that it constitutes a mechanical barrier to the entrance 
of the spermatozoa. When this is not the case it will 
be so acid as to destroy the vitality of the spermatozoa 
and the sterility is as certain as if they did not reach 
the locality at all. I have known many physicians to 
fall into error in the matter because they were 
misled about the possibility of the mechanical impedi- 
ment when the canal was so much larger than normal. 

A cure of this ailment is essential to the fruitfulness 
of the female and can be effected by a proper and per- 
sistent course of treatment, but to give a course of 
treatment so that it would be available, would require 
more space than is at our present disposal, and the 
patient is referred to works on the subject. Consti- 
tutional treatment alone will not always be successful, 
and local measures are often demanded. The internal 
employment of Dr. Dye's Mitchella Compound already 
mentioned may succeed and is worth a trial. Its effect 
may be aided by injections, more particularly for clean- 
liness, and the use of pieces of cotton batting, saturated 
with glycerine and placed against the neck of the womb. 



284 PAINLESS CHILDBIRTH 

The action of the glycerine is to set up a drainage of 
the watery elements of blood contained in the minute 
blood vessels of the uterine neck and thus relieve the 
turgescence and stagnation. They are to be repeated 
daily or at least every other day for a considerable 
time, but omitted at menstruation. Medicating the 
glycerine with one eighth part of tincture of iodine, 
golden seal, calendula, etc., sometimes increases the 
efficacy. 

It is scarcely necessary to allude to malformations 
or anatomical defects other than those already con- 
sidered, for the public are aware of their influence on 
fecundity. Some may, however, be remedied by surgi- 
cal means, and we would urge all women whose happi- 
ness depends upon their anatomical perfection not to 
be discouraged until they have consulted some good 
surgeon. It would be the part of wisdom, however, 
when a malformation exists not to enter matrimony 
until a surgeon has been consulted. 

The foregoing causes of sterility are mechanical in 
their operation and the removal of the cause by medi- 
cal or surgical means will usually be followed by relief 
of the maternal disability. Should the sterility con- 
tinue more than two years after the removal of any of 
the causes already considered, some other cause will 
have to be sought, among which the most frequent 
are the following: 

Acrid vaginal discharges, membraneous dysmen- 
orrhea, menstrual derangements, uterine and ovarian 
debility, sexual excesses, sexual apathy, ovarian dis- 
ease, late marriages, imperfect development of ovaries, 
displacement of ovaries, stricture of fallopian tubes, 



STERILITY 285 

temperamental incompatibility, disease of husband, 
nursing, etc., etc. 

Acrid vaginal discharges prevent conception by 
destroying the spermatozoa before they reach the germ 
cell. Usually this trpuble will be considered as leu- 
corrhoea and properly enough so, yet experts assure 
us that some forms of leucorrhoea, or "whites," do not 
cause barrenness, while others do. Facts of the kind 
are within the knowledge of nearly every observing 
person. The leucorrhoeal secretion is not always the 
same, but admits of a great variety of modifications, 
and some forms are so very acid that they are as de- 
structive to cell life as a solution prepared in the labora- 
tory of a chemist could be. In such cases, particularly 
if long continued, there will usually be soreness of the 
parts caused by the corrosive character of this dis- 
charge. 

While a cure is always desirable it is not always so 
easily effected. A lotion of permanganate of potash, 
ten grains in a pint of water, used freely, is very valua- 
ble; still there may be constitutional troubles on which 
the discharge depends that will need attention as well 
as the local trouble. The sepia of the homeopathic 
school I have found exceedingly valuable in such cases 
as an internal remedy. Locally, a great variety of 
remedies have been employed, but as it is only as a 
cause of sterility w^e are considering it we may say 
that if the spermatozoa can escape the deadly influence 
of this secretion and enter the uterus, conception may 
be effected. The use of injections before the sexual 
act, to remove as much as possible of this secretion, 
will increase the probability of success, and if after the 
use of an injection of warm water, which is made for 



286 PAINLESS CHILDBIRTH 

the purpose of cleanliness, an injection of milk is used, 
the probabilities of success are enhanced, the object 
being to protect the male element in its passage to the 
womb by removing the vaginal secretions or by render- 
ing them harmless. 

Membraneous dysmenorrhcea is that form of painful 
menstruation in which the flow is expelled with shreds 
of tough membrane, or perhaps with complete casts 
of the interior of the uterus. Although it does not 
always cause barrenness, it is likely to do so. Its 
pathology is not well understood. It causes sterility 
by preventing the united sperm and germ cells from 
securing an attachment to the walls of the uterus so 
that development can occur or carries them away with 
it when it is expelled. It is difficult to cure. When 
conception does occur it must take place soon after 
menstruation. It may exist in the single. When the 
disease is removed, among the married, pregnancy 
results. It has been thought that pregnancy would 
cure it, but instances have come to knowledge where 
the women had borne more than one child and still 
did not get relief from this trouble. 

Menstrual derangements usually cause sterility, 
particularly when the flow is profuse, by washing away 
the impregnated ovum. When there is menstrual de- 
rangement, a functional disease of the womb or a 
disease of the ovary is apt to co-exist, which may pre- 
vent the perfect development of the germ cells and thus 
cause the union of the male and female elements to 
be futile. The use of Dr. Dye's Mitchella Compound 
will be found of great value in these cases. Rectify 
the derangement and pregnancy may then occur. There 
is a plant known as senecio aureus, or life root, which 



STERILITY 287 

may be used with Mitchella Compound in infusion or 
syrup. Sometimes the derangement results from a low 
grade of vitality on the part of the woman, and when 
such is the case the preparations of iron are of value. 
If from congestion with dragging down, aching, etc., 
the use of small doses of belladonna may so far over- 
come it as to favor conception. Fifteen drops of the 
homeopathic tincture in four ounces of water and a 
teaspoonful taken every four or five hours often suc- 
ceeds in overcoming this latter condition. 

Uterine and ovarian debility causes sterility by im- 
perfectly developing the germ cells or by imperfectly 
nourishing them after they are fecundated. Where 
there is no constitutional debility we may attribute 
the sterility to purely local debility or inertia. In case 
there is constitutional debility a course of tonics are 
proper. Iron, squaw vine, life root, quinine, nux vomica, 
etc., in proper doses will often be followed by the de- 
sired results. In case of a purely local inertia or de- 
bility, the use of electricity, passing the current through 
the body from the lower part of the back to the point 
over the pubes, may succeed. The use of an electrical 
current passed into the uterus by one pole of the 
battery being introduced into it, the other over the 
back, is sometimes successful, and so is the application 
of a strong child to her breasts. There is a sympathy 
between the breasts and womb and ovaries, and by 
the reflex influence the natural function is so acted 
upon that conception at that time may be effected. 

Sexual excesses exhaust the vitality of both parties 
to such an extent that the germ and sperm cells may 
not be sufficiently viable to perform their part in repro- 
duction. By a wise provision of nature such devitalized 



288 PAINLESS CHILDBIRTH 

elements are frequently unproductive, and it is well 
that it is so. The remedy lies in modifying the indul- 
gences to a frequency consistent with vitality, correct- 
ing the debility with a judicious course of tonic medi- 
cines and, if necessary, such a course of local treatment 
as has been advised under the preceding section — 
electricity, cold bathing, sea bathing, etc. 

Sexual apathy, while not an absolute cause of ster- 
ility, may properly be considered as one of them. 
Many women bear children who do not experience the 
least sexual desire; yet others are barren on that ac- 
count. When such is the case, an inquiry into the causes 
of the sexual apathy is necessary and the case treated 
according to such indications as may be rendered appa- 
rent by the investigation. The fact that sterility is not 
always caused by the absence of sexual senses leads 
us to the presumption that it is only in certain forms 
of this condition that sterility results, consequently the 
course of treatment selected will have to be dependent 
upon the cause. The use of tonics, electricity, injec- 
tions of stimulating substances, as ammonia (weak), 
tincture of myrrh, etc., are sometimes valuable, as is 
the internal administration of musk, phosphorus, iron, 
quinine, etc., in proper doses, which may be deter- 
mined from any work on Materia Medica. 

Ovarian diseases prevent conception by preventing 
the development of the germ cells entirely, or by 
causing them to be so imperfectly developed that they 
cannot perform their part. The consideration of dis- 
eases of this kind is not within the scope of this work, 
while displacement of the ovaries, their imperfect 
development, together with stricture of the fallopian 
tubes, are of such a nature that a consideration of 



STERILITY 289 

them would be of no value to the sterile woman, for 
nothing she can do will be likely to afford her relief, 
and we must refer them to those who make such ail- 
ments a specialty. 

The period of the greatest fecundity occurs on an 
average between the ages of twenty and twenty-four, 
and the farther the latter period has passed without 
the woman becoming a mother, the greater are the 
chances that she never will be thus favored. This is 
more particularly the case where no organic disease 
of the womb or ovaries exists as the prime cause. There 
are very many notable exceptions to this rule, and if 
some other cause may not be determined we would 
not advise the woman to be discouraged, for possibly 
nature may bring about some mysterious (?) change 
that will result in her maternity. Horseback exercise 
has sometimes been beneficial in these cases, partic- 
ularly when carried to excess. Just before or a few 
days after the menstrual period conception is most apt 
to occur, particularly if total abstinence is practiced 
in the interval. 

Nursing is a fruitful cause of unfruitfulness, though 
not absolutely certain, for instances are constantly 
coming under observation in which conception occurs 
during nursing. It is supposed the reason is because 
the vitality of the woman is expended in supporting 
the child at the breast, by the secretion of the milk, 
during which time the ovarian and uterine function 
is suspended. After weaning, conception is very likely 
to occur, particularly if the mother has not seriously 
deteriorated in health. 

Very often the woman is blamed for unfruitfulness 
when she is entirely innocent and the husband is the 



290 PAINLESS CHILDBIRTH 

real culprit. Knowing as I do the extensive prevalence 
of self-abuse and its ruinous consequences on not only 
the reproductive organs but the general system, I can 
easily understand how the spermatozoa may be so 
defective that they cannot impregnate the germ cells 
of the woman, no matter how perfectly developed and 
matured these may be. The seminal fluid of the male 
does not always contain perfect spermatozoa, and if 
no good cause can be assigned for the sterility on the 
part of the wife it is well to inquire into the condition 
of the husband before the wife is subjected to censure. 

The husband may have had some disease at some 
time of his life that has impaired the functions of the 
testicles, or he may have done so by leading a lecherous 
life, and I am satisfied after years of experience in the 
treatment of these affections that many a wife has 
been unjustly blamed in the matter. 

Temperamental incompatibility is a cause often 
mentioned and, while it is possible, it is too little under- 
stood to be very often considered in the question of 
reproduction farther than to the inheritance of pecu- 
liar constitutions; electro-positive and electro-negative 
conditions are essential to the harmony and procrea- 
tive success of a matrimony. It may appear a little 
far-fetched, when we consider that the polarity of 
organs or bodies may be more or less modified or 
changed by circumstances, excitement, etc., yet an 
inquiry into the causes of sterility could not very well 
evade its consideration, and if both parents are similar 
in temperamental and magnetic qualities they may be 
unfruitful, while the same parties united to others 
would be fertile. 



STERILITY 291 

No better illustration of this subject is needed than 
the well-known one of the first Napoleon and Josephine. 
She had had children in her first marriage; he became 
a father in his second. True, there may arise a question 
of Josephine's fertility with another husband at the 
time — a question that will no doubt always remain 
open. It is, nevertheless, a recognizable fact that 
certain parties are illy adapted to each other, socially 
at least, and though the question of temperaments 
has furnished a fine field for quackery, but little as yet 
is definitely known of it as a cause of sterility. There 
are many questions that rise before me as I write, 
but their consideration might lead in some cases to 
domestic infelicity without doing much to unravel the 
mystery, and it is best that its consideration be made 
the subject of a private consultation in which all the 
peculiarities of the individual concerned may be con- 
sidered, or submitted to those who delight in such 
metaphysical (?) inquiries. 

The question of temperaments, however, is one that 
should receive attention from marriageable people even 
aside from its influence on fertility and the fruitfulness 
of the union. It is easy enough to follow the subject 
in the divisions laid down by those who have made 
the study a specialty, and to say who are best adapted 
to each other, but to carry the question to a consid- 
eration of sterility is extremely difficult, because there 
may be circumstances connected with the sexual life 
of a husband and wife, before or after marriage, that 
no inquiry except made in individual consultation 
would reveal, and I must confess that the subject in 
the present state of society seems a very unproductive 
one. 



292 PAINLESS CHILDBIRTH 

We have already considered the most frequent causes 
of barrenness and pointed out the indications for their 
removal, many of which we are sorry to acknowledge 
cannot be carried out wholly by the woman herself. 

In the treatment it may sometimes be found that 
after the removal of some cause the sterility will con- 
tinue. When this is the case some other cause must 
be sought, for it so happens that occasionally a combi- 
nation of causes may exist. The researches of Dr. Sims 
have shown that for the most part the causes of ster- 
ility are mechanical, and that the removal of the 
mechanical cause is followed by pregnancy in a large 
proportion of cases. It has been my endeavor to show 
the barren woman the operation of those causes and 
to point out others which may offer an opposition to 
her happiness. There are, however, still others which 
do not admit of any general classification, but they 
are not very frequent, and it is presumed that they 
operate remotely rather than by being causes within 
themselves. Of these we may mention season, climate, 
social position, sexual relations, etc. 

It is claimed that spring is the most favorable season 
for fecundity. Climate no doubt has much to do with 
fecundity and barrenness, but it is no doubt due to 
the influence it exerts upon the general health, though 
it is said that the southern climate is more favorable 
than the northern. Perhaps this may be accounted for 
by the difference of the sexual dispositions of those 
who live in the different climates. Sterile women travel- 
ing with their husbands, sometimes find that an ocean 
voyage, or a trip to some other climate, so modifies and 
improves their general health that it ultimates in their 



STERILITY 293 

becoming mothers. Social position no doubt has some- 
thing to do with fecundity, and without making any 
inquiry into the sexual relations of the rich and poor, 
I will state that women who live in luxury and fashion 
are not so prolific as their poorer sisters. Those who 
are in the best circumstances to care for large families 
rarely have as many children as those who find it 
difficult to provide for them. It is said that in Belgium 
the higher the price of bread the greater the number of 
children, and the greater the infant mortality. In 
another chapter allusion has been made to the greater 
prevalence of uterine disease among wealthy ladies in 
proportion to their numbers, which may partially 
account for the difference in the size of families. On 
the other hand, many weak and feeble women have a 
numerous progeny. 

Sexual relations no doubt exert a greater influence 
upon fecundity, fertility and sterility than is generally 
supposed, and this is not only in relation to the rela- 
tive conditions of health, but also to the other rela- 
tions married people sustain to each other. The sub- 
ject, however, is one which, while the reader might be 
specially desirous of understanding, my regard for 
propriety forbids its consideration in this place. Should 
those thus affected choose to consult me personally 
or by letter I will endeavor to enlighten them as far 
as possible. 

There is an inadaptability often existing between 
the parties to a marriage contract that renders their 
lives unhappy and prevents them from having children. 
These troubles require skillful treatment and are gener- 
ally of such a character that they yield readily when 
the requisite skill is obtained, and no one should be 



294 PAINLESS CHILDBIRTH 

discouraged if they should be unfortunate enough to 
at first fall into the hands of quacks, for those unprin- 
cipled rascals are plenty and are ready to palm them- 
selves off for scientific physicians. The sterile will do 
well to consider the subject and ask themselves the 
question, what is wrong? When people live unhappy 
lives, who is to blame? Are both, or is only one? 

Such queries may lead them to be more forgiving 
to each other and thus relieve the mental causes of 
sterility. This may seem far-fetched and will perhaps 
be criticised by those who can see only causes of ster- 
ility in the tangible conditions already considered; yet 
if the mind can influence ante-natal conditions so as 
to cause " birth marks/' may not lack of mental, 
moral, social, sexual and domestic harmony be equally 
as unfavorable to the occurrence of conception as to 
the perfect development of the child that has been 
conceived? 

In closing, the author hopes that a consideration of 
this chapter will be the means of directing unhappy 
and sterile wives to the realization of their maternal 
desires as well as by previous chapters to relieve the 
fertile ones of the difficulties and dangers, the pains 
and the perils of childbirth. 



CHAPTER XVIII 



DISEASES OF CHILDREN 

Children are subject to various disorders, the lia- 
bility to at least some of which diminishes as they 
advance in age. It is estimated that fully one fourth 
of all the children born, die before reaching their seventh 
year. 

To know what to do before the arrival of the family 
physician or in his absence is often of very great advan- 
tage, and the writer hopes his suggestions may be of 
practical value to the anxious parent and an aid to 
the physician in the performance of his many duties. 

As the unprofessional reader will derive little or no 
benefit from pathological considerations I shall omit 
them almost entirely and, instead of pursuing the 
usual arrangement of diseases by groups and classify- 
ing them according to their pathology, I shall consider 
them in a manner that seems to me to be of the greatest 
convenience to the reader, endeavoring to render the 
subject as intelligible and practical as brevity will 
permit. 

Unless otherwise specified, the doses advised in this 
chapter will be for children from one to four or five 
years of age and should be increased for those older, 
adding about half as much more for children between 



296 PAINLESS CHILDBIRTH 

five and ten, double from ten to fifteen and treble for 
adults. This plan Vvdll be rather more convenient than 
the old one of graduating the dose by years from one 
to twenty-one, particularly as I do not intend to pre- 
scribe remedies in such a manner as to endanger life 
by the difference of a fraction of a dose. 

It requires not a little tact and discrimination to 
properly investigate the disorders of childhood, partic- 
ularly among very young children. We are compelled 
to depend upon signs almost entirely. These should 
be well understood by the mother or nurse, for the 
attending physician must derive his information largely 
from those who are constantly present, and as many 
of these signs appear only at intervals a habit of obser- 
vation should be acquired that every sign may be 
noted at its occurrence. 

GENERAL SIGNS 

Among the sources from which information may be 
obtained in children who cannot convey a knowledge 
of their condition by speech, are the countenance, 
gestures, attitude, breathing, ■ circulation, sleep, cry, 
discharges, skin, temperature, odors, the tongue, ag- 
gravations, etc. We are to make use of our senses, 
see, hear, feel and even smell ! Some diseases generally 
appear at certain seasons of the year. The prevalence 
of epidemics should put us on our guard. 

The expression of the countenance varies with the 
stages of the disease as well as in different diseases. 
In affections of the brain and nervous system, the 
forehead is contracted and heavy, the brows knit, the 
eyes vacant, expressionless or wild, staring, fixed, some- 
times squinting, bloodshot, half open, dropping of the 
lids, the pupils contracted in the early stages of the 



DISEASES OF CHILDREN 297 

disease and dilated later on; the face is generally hot 
and flushed, spasmodic drawing of the features in 
twinges of pain. Sometimes the upper lip will be drawn 
tightly over the teeth and perhaps be almost livid. 

In diseases of the liver, the skin and eyes become 
yellow and sodden. 

In worms, and intestinal irritation from other causes, 
the nose and upper lip are apt to be swollen, the white 
of the eyes of a pearly cast, a sharp white circle around 
the mouth, and if fever is present the rest of the face 
flushed. 

In bowel diseases, the cheeks are sallow, sunken, 
mouth compressed and the lips drawn, dry, dark, 
parched and, as the disease progresses, anxiety, ema- 
ciation, the chin prominent, the eyes sunken and hol- 
low; if not stupid, the whole features sharp; as exhaus- 
tion comes on, the face is alternately flushed and pale, 
hot and cold; and in the latter stages the face is glisten- 
ing, pale, cold, eyes sunken, half closed, lips parched 
and the features pinched. 

In diseases of the respiratory organs, as pneumonia, 
bronchitis, etc., the face is flushed dusky red, nostrils 
working, dilating with each inspiration and contract- 
ing with each expiration, the brows knit, lips livid, 
sharp, dark circle around the mouth, and in advanced 
cases, emaciation, etc. 

In measles, the whites of the eyes are red, the eyes 
watery, overflowing, squinting, avoidance of light, 
the lids swollen and the general appearance as if crying. 

In scarlet fever, the eyes are often red and watery, 
but never overflow, and give the appearance of crying, 
as in measles, and the intolerance of light is not so 
marked. 



298 PAINLESS CHILDBIRTH 

In chronic diseases, the face pales and flushes at 
intervals, the eyes sunken and pupils dilated, with 
circles beneath, the whites muddy, the cheeks hollow 
(particularly in diseases of the nutritive organs), 
sunken, complexion sallow. In diseases of the lungs, 
the cheeks are sunken, emaciated, pale, with a circum- 
scribed redness, the eyes often unusually bright. 

The attitude and gestures aid in indicating the loca- 
tion and character of the disease. Early, there will 
be inattention to surrounding objects, languor or rest- 
lessness. In inflammatory diseases of the chest and 
abdomen, motion will be avoided as much as possible, 
the position, on the back with the knees bent and drawn 
up, sharp cries as there is sudden twinges of pain. As 
a rule the pain of inflammation causes the child to 
lie very still. Spasmodic pain causes the child to start 
in terror and writhe and twist about as the muscles 
are caused to suddenly contract. In convulsions, the 
head is thrown backward, the eyes roll upward, the 
hands clenched, an arm becomes rigid, a leg drawn 
upward, the toes are drawn downward, the thumbs 
drawn into the palms of the hands, the child starts 
or screams or perhaps becomes unconscious, the breath- 
ing is spasmodic, perhaps frothing at the mouth, 
gnashing or grinding the teeth. 

In inflammation of the brain or its membranes, the 
head is rolled from side to side as the child lies on its 
pillow, the hands make sundry motions in different 
directions and are frequently raised to the head, 
clutching at the hair or cap as if endeavoring to tear 
them away. 



DISEASES OF CHILDREN 299 

In diseases of the mouth, teething, etc., it works at 
the mouth, bites, throws itself, rubs the gums, etc., 
and may have convulsions. 

In croup and other suffocating diseases, the hands 
clutch at the throat, press it from side to side, the 
child struggles to maintain the upright position with 
the head thrown back to favor the entrance of air 
into the lungs. 

The cry is indicative of displeasure, uneasiness or 
pain. In affections of the lungs, it is a sort of a 
groan. In croup, it is a hoarse, peculiar, metallic or 
crowing sound. In acute diseases of the brain, it is 
one single sharp, powerful cry at distinct intervals. 
In diseases of the bowels, it is a low moaning sound. 
Shedding tears during a sickness is regarded as a 
favorable sign. 

The discharges should always be noted. They may 
be scanty, excessive or perverted. When there is vomit- 
ing, it should be noted to see if it is sour, thick, watery, 
clear, opaque, yellow or green, or if it contains food. 
Improper food is often got rid of by vomiting, or pass- 
ing onward into the bowels it creates colic or diarrhoea. 
Diseases of the stomach are often characterized by 
vomiting, when it may contain the undigested food 
mixed with other matters. Yellow or greenish dis- 
charges indicate the presence of bile. Vomiting is 
nature's provision for the removal of an excessive 
amount of food in infancy. In cholera infantum the 
vomiting is persistent, watery and mixed with the 
food. It is one of the first symptoms of some eruptive 
fevers and often terminates a paroxysm of whooping 
cough. Diseases of the brain and injuries to the head 
may cause vomiting. 



300 PAINLESS CHILDBIRTH 

The stools, if frothy, sour or green, indicate de- 
rangements of digestion and are generally attended with 
griping. Slimy stools are usually present during teeth- 
ing and when worms are causing trouble. Blood and 
mucus indicate dysentery. Thin, offensive stools, vary- 
ing in color from light to dark, are the principal charac- 
teristics of diarrhoea, and clay-colored discharges indi- 
cate deficient action of the liver. The frequency of 
the stools should be observed, for even though they 
present no unnatural appearance, if too frequent they 
indicate defective appropriation of nourishment and are 
apt to contain undigested food. 

The urine is scanty, highly colored, has a strong 
odor and is generally loaded with a branlike sediment 
in fevers, inflammations and rheumatism. The quan- 
tity, color and smell may be ascertained by observing 
the diapers of children too small to use a urinal. In 
diabetes, it is clear and profuse. In nervous disorders, 
it is apt to be profuse, and on standing deposits a 
dirty whitish sediment and soon becomes offensive. 
In diseases of the bladder, it will be passed often and 
but little at a time. In affections of the liver, it will 
have a yellowish or saffron color. 

The circulation in infancy is more variable than in 
adults, the pulse more rapid and easily influenced, 
and is not as reliable as a diagnostic means in infants as 
in grown persons. 

The skin and its temperature are influenced by 
disease. It is hot and dry in fevers and inflammations, 
cool and moist in constitutional weakness. Profuse 
sweating with cold, clammy skin indicates debility. A 
doughy, inelastic skin is apt to be present in tubercular 
or scrofulous affections. It is yellow in jaundice, sallow 



DISEASES OF CHILDREN 301 

and sodden in diseases of nutrition. A bluish tint 
points to structural disease of the heart. It is red in 
fevers and eruptions, purplish or livid when the blood 
is imperfectly oxygenated, and dry and harsh in dia- 
betes and Bright's disease. 

The temperature has of late years become an impor- 
tant aid to diagnosis, and furnishes moderately relia- 
ble indications of the probable result. In health it is 
about 983^2° Fahr., and any persistent or considerable 
deviation from this standard denotes disease, and the 
greater the rise the greater the danger. The tempera- 
ture can be determined only by a thermometer designed 
for the purpose. As it sinks below the natural standard 
during the progress of a disease it indicates danger of 
collapse, though in diabetes it is usually one or two 
degrees lower than in health. It rises in fevers and 
inflammatory diseases, and if the rise is persistent shows 
there is severe illness and danger. When it rises to 
or above 106°, recovery is rare, unless the rise is only 
temporary. 

Odors are not easily described, but a knowledge of 
them serves a very useful purpose. In measles or small 
pox, there is a peculiar smell that once observed will 
seldom be forgotten. In lung diseases, a yeastlike odor 
is often present. In stomach and liver diseases, the 
breath is sometimes very offensive. A peculiar smell 
accompanies fevers. In rheumatism, the perspiration is 
usually sour. When the stools have a sickening, cadav- 
erous odor during any disease it indicates danger. 
Urine during protracted fevers, inflammations, etc., 
may have an ammoniacal odor, and indicates danger. 

The tongue furnishes the intelligent practitioner 
with a vast amount of information. In health, the 



302 PAINLESS CHILDBIRTH 

mouth is moist and pale, the tongue moist, pale and 
partially covered with whitish mucus. When loaded 
with whitish curdy matter there is generally disturb- 
ance of digestion. A dry tongue is common in most 
febrile diseases. If it becomes moist after having been 
dry and furred, it is favorable. It is fissured in typhoid 
fever. Redness and dryness is present in inflammatory 
diseases of the alimentary canal; in the eruptive fevers, 
it is very red; it also indicates acute indigestion. A 
heavy fur shows disease of mucus membranes and, if 
yellow, disease of the liver; and a brown or black fur, 
a low state of the vital forces and, if dry, danger. A 
large, pale, flabby tongue indicates debility and tardy 
retrograde metamorphosis. A heavily coated, moist 
tongue indicates derangement of the secretions with- 
out inflammation. Redness of the tip and edges of the 
tongue indicates irritation of the stomach or upper part 
of the intestines. Gradual clearing of the tongue during 
disease indicates a tendency to recovery. If the tongue 
becomes browner, drier, dirtier each day, and the nerv- 
ous system more feeble, the hope of recovery fades. 
When the fur comes off suddenly or separates in patches, 
leaving a glossy surface beneath, it is unfavorable. 

Although the foregoing indications are not as com- 
plete as if this work were intended mainly for the 
guidance of physicians, and admit of many exceptions, 
they furnish many valuable guides to the recognition 
and location of diseases — an outline to diagnosis — as 
will be observed in the consideration of the following 
diseases. 

EXCORIATIONS AND ULCERATIONS 

Without the greatest attention to cleanliness, 
children are apt to get chafed behind the ears, in the 



DISEASES OF CHILDREN 303 

wrinkles of the neck and groin, and about the arms. 
This causes the child untold suffering, and unless it 
receives proper attention is apt to degenerate into 
more or less extensive ulcerations. 

Treatment.— The prompt removal of discharges 
and carefully washing and drying the child will go far 
towards obviating this trouble, yet in fleshy children 
this alone may not be sufficient and additional means 
will be required. Bathe the irritated parts with warm 
milk and water, rejecting the common coarse soaps 
of commerce and, after drying carefully with a soft 
cloth, sprinkle with powdered starch and lay into the 
folds of the skin a bit of scorched linen rag. Dusting 
the parts with powdered lycopodium, which can be 
got at any drug store, is also an excellent means of 
preventing serious ulcerations, giving almost instant 
relief in chafes. When the trouble is persistent, bathing 
the raw surfaces with an infusion of golden seal is a 
very reliable remedy. The strength of the infusion 
should be a teaspoonful of the powdered root in half 
a pint of water; after standing a few hours, strain. 
To this we may add a little borax or in some cases ten 
grains of sulphate of zinc will do better. 

In children of a scrofulous habit there is a disposi- 
tion in such cases to form extensive sores, and atten- 
tion to the child's general health becomes necessary. 
We must see that it receives proper nourishment and 
then give some alterative as: 

Compound Syrup of Stillingia, . 4 ounces 
Fluid Extract of Bayberry, . 3^ ounce 

Dose. — One fourth to one half teaspoonful three times a day. 
At the same time continuing the lotion of golden seal and zinc. 



304 PAINLESS CHILDBIRTH 

If this does not cure in a reasonable time, it might 
be well to substitute Peruvian bark for the golden 
seal and prepare and use it in the same manner. 

VOMITING 

Vomiting is often caused by overfeeding, and is one 
of nature's methods of disposing of surplus food. When 
it results from this cause, careful regulation of the diet 
will generally be all that is required. 

For the most part vomiting is symptomatic of other 
diseases, though it may exist as a disease itself. 

When it occurs in dyspepsia the food is usually un- 
digested, in a state of fermentation, and the bowels 
deranged. In such cases the bowels require some laxa- 
tive, such as castor oil, rhubarb or calomel, or we may 
put five drops of the fluid extract of nux vomica in a 
glass of water and give a teaspoonful every three or 
four hours. It exerts an excellent influence in many 
cases of chronic constipation in children and adults. 
In connection with this, give two grains of pepsin and 
a half a grain of subnitrate of bismuth either just before 
or after the meal. 

Ordinarily, five drops of the tincture of ipecac in a 
glass of water given in teaspoonful doses every hour or 
two will control vomiting, particularly if associated 
with a looseness of the bowels. 

If the tongue has a yellow coating or there is a 
yellowness around the mouth, alternate the ipecac with 
the nux vomica, prepared as for dyspeptic vomiting. 

If the vomited matter is sour, dissolve a teaspoonful 
of bicarbonate of soda in a glass of water and give in 
sips every half hour till the acidity is corrected, con- 
tinuing the nux vomica. 



DISEASES OF CHILDREN 305 

A plaster composed of allspice, cloves and cinna- 
mon, or ginger and Peruvian bark, applied over the 
stomach is an excellent auxiliary means, but is not 
to be left on too long, on account of the irritation of 
the skin it may cause. 

When vomiting occurs as a symptom of some other 
disease, the treatment recommended for that will be 
most appropriate, though the temporary use of the 
means just considered may become necessary. 

CONVULSIONS 

Spasms or fits, as convulsions are often called, may 
arise from a variety of causes. They may be symptom- 
atic of disease of the brain or nervous system, such 
as meningitis, tumors, hydrocephalus, etc., but as 
generally met with in children they are caused by irri- 
tation reflected to the brain from different parts of 
the body. In this way they are caused by the presence 
of worms in the intestinal tract, by indigestible food, 
acidity of the stomach, flatulence, teething, retention 
of urine, foreign body in the ear, surface irritation, 
as from burns or wounds, the striking in of some erup- 
tion, etc. Convulsions frequently occur at onset of 
certain diseases, especially pneumonia, scarlet fever, 
acute indigestion, typhoid fever, measles and diphtheria. 
Convulsions are common in whooping cough. The 
younger and more irritable the child, particularly if 
of a highly nervous temperament or scrofulous consti- 
tution, the greater its liability to fits from intestinal 
irritation. Convulsions are always to be regarded with 
apprehension. Four fifths of the cases of convulsions 
occur during the first two years of life. 

The symptoms vary in duration and severity, lasting 
from a few minutes to several hours, and the attack 



306 PAINLESS CHILDBIRTH 

may be repeated at indefinite intervals. There is a 
sudden and involuntary jerking of the extremities, 
twitching of the muscles of the face, grating the teeth, 
rolling the eyes, perhaps frothing at the mouth, the 
thumbs drawn into the palms of the hands, and the 
hands clenched and the toes drawn downward. The 
pulse may be accelerated and irregular, small or hard, 
and the face pale, flushed, or slightly blue, especially 
about the lips. Beads of cold sweat often cover the 
forehead. 

The contents of the bowels or bladder may be ex- 
pelled and consciousness may be wholly or partially 
lost. Toward the end of the convulsion the jerking 
becomes less frequent and less severe — there is a long- 
drawn breath and the child passes into a sleep or coma. 
The premonitory symptoms, twitching of the face, 
grinding of the teeth, without actual convulsions, are 
often denominated inward fits. 

In the treatment, we must be governed by the cause 
as far as possible. If the premonitory symptoms are 
noticed or if the child can swallow give a few spoonfuls 
of salt and water. It is always at hand and is an excel- 
lent remedy. It may be given freely, for it will only 
cause vomiting if more than is necessary be taken, 
and this is often desirable. Put the feet in hot mustard 
water, and if the head is hot and the face flushed apply 
cloths wet in cold water to the head. It is better, how- 
ever, to put the child at once in a hot bath (about 100 
F.). Keep the head raised and apply to it cloths wet 
in cold water. Do not wait to undress the child before 
placing it in the water — that can easily be done whilst 
giving the bath and rubbing the body. The bath should 



DISEASES OF CHILDREN 307 

last about five minutes and then the baby should be 
taken out and wrapped in a warm blanket. 

The inhalation of a few drops of chloroform or 
ether from a napkin held near the nose almost always 
affords relief. Prevent biting of the tongue by placing 
a knife handle, spoon, etc., between the teeth. Give a 
copious warm rectal injection of soap and water to 
clear out the lower bowel. 

When the convulsions are caused by the irritation 
from teething, and the gums are hot and swollen, give 
a teaspoonful of the following, every hour: 

Tincture of Gelseminum, . . 3^ dram 

Bromide of Potassium, . . 1 dram 

Water, ..... 2 ounces 
*Ten drops of the fluid extract of gelseminum may be substi- 
tuted for half a dram of the tincture, if the tincture is not at hand. 

Discontinue it when the fit is broken, or continue 
it in smaller doses every three or four hours. 

When due to worms, give the salt and water already 
mentioned, pumpkin seed tea or ten drops of turpen- 
tine in a teaspoonful of castor oil, increasing the dose 
for a child over three years old. Follow this with the 
treatment laid down under the head of worms, which see. 

If the fit is caused by irritation of the stomach or 
bowels from indigestible food, give an emetic of ipecac 
or lobelia, 10 or 15 drops in warm water, and repeated 
every 15 minutes till free vomiting ensues. One half 
a teaspoonful of ground mustard in a cup of warm 
water given part at a time is a very prompt emetic 
and almost invariably at hand. Follow the emetic 
with a dose of castor oil to move the bowels, or the 
neutralizing mixture mentioned in the latter part of 
this book. (Page 411.) 



308 PAINLESS CHILDBIRTH 

If the stomach is sour, give the neutralizing mixture 
or, if not at hand, put a teaspoonful of bicarbonate of 
soda or saleratus in a gill of water and give it in table- 
spoonful doses every 10 or 15 minutes. Attention to 
the bowels is necessary, and as the neutralizing mix- 
ture accomplishes both purposes it is preferable. 

A highly sensitive condition of the nervous system 
predisposes to fits, and the gelseminum and bromide 
of potash already mentioned will be found an excellent 
remedy to modify this condition and thus prevent the 
fits, but attention to the removal of the causes is nec- 
essary and must not be forgotten. 

When the convulsions are due to the sudden strik- 
ing in of some eruption, use the warm bath at once, 
and be careful in removing the child from it that a 
chill is not experienced. At the same time give: 

Tincture of Aconite, ... 5 drops 
Tincture of Belladonna, . . 5 drops 

Water, ..... 6 ounces 
Dose — A teaspoonful every half hour to one hour. 

Call the family doctor in the meantime, as the 
troubles are sometimes complicated and need combined 
treatment. 

COLDS 

Although most people regard a common cold with 
indifference, a writer has well said that " Colds destroy 
more lives than any other cause." They result from 
exposure in some way or other and are too well known 
to require any description. All are liable. They may 
affect any or all parts of the body. Colds vary greatly 
in severity, and their frequent repetition lays the found- 
ation for severe and often fatal diseases. Indeed, colds 



DISEASES OF CHILDREN 309 

are the immediate cause of a large percentage of our 
diseases. 

Treatment. — Colds should always receive prompt 
attention, for neglect is often fatal. Give a hot foot 
bath on going to bed and drink a cup of warm catnip, 
boneset or composition tea, cover warm and encourage 
perspiration, but be careful the next day not to renew 
the attack. A mild cathartic after the sweat will aid 
in breaking up the cold. Hot lemonade at night has 
enjoyed a good reputation. 

Five to ten drops of aconite in a goblet half full of 
water, given in teaspoonful doses every half hour or 
hour until perspiration is established, is good treatment 
for either child or adult. An alcoholic or spirit vapor 
bath is always beneficial. 

INFLUENZA— LA GRIPPE 

This is an acute contagious disease, often appearing 
as an epidemic. Most writers consider influenza and 
colds together, but as the former is usually so much 
more severe I have separated them with the view to 
impress the importance of prompt and efficient treat- 
ment, for while the disease may not be fatal itself it 
often lays the foundation for chronic nasal catarrh, 
bronchitis and even consumption. 

Symptoms. — An attack of influenza is generally 
ushered in with chilliness or rigors, lassitude, stiffness 
and soreness of the muscles, sneezing, a dryness or 
increased discharge from the nasal cavity, oppressed 
breathing, soreness of the throat, redness and watering 
of the eyes, the nose sore and swollen, thirst, etc. With 
these symptoms there is a fever of varying severity 
which is apt to remit in the morning. The tongue is 
coated, the bowels deranged and the urine scanty and 



310 PAINLESS CHILDBIRTH 

highly colored. A troublesome cough comes on, at 
first dry and irritable, which in time is followed by 
expectoration, the child snuffles, and in adults the se- 
cretion sometimes becomes so profuse as to keep the 
person " hawking'' or spitting all the time. There is 
more or less dullness of the intellect, headache, darting 
pain, and in some cases there may develop croup, 
bronchitis or pneumonia. 

Tkeatment. — In mild cases of influenza the symp- 
toms will so nearly resemble a common cold that unless 
an epidemic of the disease is prevailing it will be im- 
possible to distinguish between them. The treatment 
advised for colds is appropriate in mild cases, but in 
severer ones a more thorough course may be necessary. 
Keep the little patient in bed, give liquid foods and 
apply hot applications to chest or other painful parts. 
An old-fashioned domestic remedy of considerable 
efficacy, I well remember, in " childhood's happy 
hours," consisted of vinegar, molasses and butter 
stewed together and taken hot on going to bed; for 
an adult a large cupful was a dose. 

In the early stages of the disease a thorough sweat 
is decidedly appropriate. A spirit vapor bath (de- 
scribed elsewhere) aided by a hot mustard foot bath 
and the warm teas advised for a cold, followed by the 
use of aconite as for a cold, and pushed till the pulse 
is regulated and the fever controlled will in nearly 
every case cut short the attack. Allay thirst with drinks 
of lemonade, flaxseed tea or water. 

If the bowels are constipated give some mild laxative, 
but always bear in mind to so time it that it will not 
be operating on the bowels when the patient is bathed 
in perspiration. 



DISEASES OF CHILDREN 311 

If the symptoms of nasal catarrh predominate, 
snuff up the nose some warm salt and water (one 
teaspoonful of salt in one pint of water) or spray nose 
with Dobell's Solution. Inhaling the vapor of ammonia 
often acts equally well, and is almost always to be 
found in every house. The vapor of camphor is also 
excellent. Put a teaspoonful of the spirits of camphor 
into a teacup of hot water and inhale the vapor as it 
arises, snuffing it well up the head. 

Another. — Into a wide mouthed bottle, capable of 
holding an ounce, mix two drams each of carbolic acid 
and spirits of hartshorn; then put in cotton batting 
enough to absorb the mixture, and inhale the vapor, 
keeping it corked when not in use. The evolution of 
the vapor may be increased by setting the bottle in 
a cup of hot water during inhalation. 

When the severity of the disease is spent on the 
chest, the following will relieve the inflammation and 
soreness, promote expectoration and overcome the 
cough: 

Tincture of Aconite, ... 10 drops 
Tincture of Bloodroot, . . 1 dram 

Paregoric, .... 3 drams 

Compound Syrup Squills, . . 12 drams 

Mix. Dose — For a child two to five years old, 10 to 15 drops 
three or four times a day. For an adult a teaspoonful. 

If there is a sense of dryness in the throat and bron- 
chial tubes, a whistling noise in breathing, a poultice 
of flaxseed applied to the chest as warm as can be borne 
will aid in its relief. 

Great care must be taken not to catch a fresh cold 
during the course of the disease, which is apt to con- 
tinue a week or two, unless the treatment cuts it short, 






312 PAINLESS CHILDBIRTH 

as it would be very apt to bring on a renewal of the 
attack more severe than at first and perhaps cause a 
serious disease of the lungs. 

After the severity of the attack is passed, tonics 
may be required, as iron, quinine, syrup of hypophos- 
phites, etc. 

SPASMODIC CROUP 

This is the ordinary croup of childhood, due to a 
spasm of the vocal cords, and is also known as false or 
pseudo croup. When the attack appears suddenly and , 
without warning, in her child, the mother is often 
alarmed and terror-stricken. The common causes of 
this distressing affection are exposure to cold and damp 
weather, indigestion, constipation, rickets and ade- 
noids. It is most common in children between the ages 
of six months and five years, and a child that has had 
one attack will be very liable to have more, especially 
when the weather is cold, damp and changeable. 

Symptoms. — The attack usually comes on suddenly 
during the night, although there may have been symp- 
toms of a cold for a day or two previously, with some 
cough and hoarseness, but not sufficiently severe to 
occasion any anxiety. 

The child is wakened suddenly from a sound sleep 
with difficulty of breathing and a peculiar brassy cough, 
which once heard can never be forgotten; the head is 
thrown backward, the skin is hot, the pulse rapid, 
the eyes protrude, the countenance expresses anxiety, 
the lips and finger tips slightly blue, the breathing 
attended with a whistling sound, the sides of the chest 
and the notch above the breast bone are depressed, 
the voice is rough and hoarse, croaking, and is finally 
reduced to a whisper. Sometimes the child is disposed 



DISEASES OF CHILDREN 313 

to be drowsy, waking as the paroxysms occur. The 
attack lasts from half an hour to three hours, and then 
the cough lessens in force, the breathing becomes easier, 
the little one breaks into a free perspiration and soon 
falls asleep, tired or worn out with its suffering. 

The next day the child seems apparently well, with 
the exception of a croupy cough or slight soreness of 
the throat. On the second night there may be another 
attack just as severe as the first, and on the third a 
lighter and milder one. 

Treatment. — During the attack apply to the throat 
cloths wrung out of hot water or wrap a cold cloth 
around the neck and place the child in a hot bath. 
A splendid method of treatment is to place the child 
in a croup tent that can be easily improvised over the 
crib by fastening a broomstick to each corner and 
covering with a blanket. An umbrella placed on the 
bed and covered with a blanket makes a good substi- 
tute. The tent is filled with steam from a croup kettle 
or ordinary tea kettle, and a teaspoonful of compound 
tincture of benzoine (Friar's Balsam) poured into the 
water adds to the value of the steam. When the ca- 
tarrhal secretion is profuse and the throat so full of 
mucus that it embarrasses respiration seriously, an 
emetic becomes necessary. Vomiting should be induced 
by tickling the throat or by running the finger down the 
throat or by giving lukewarm water and salt. From 
one half to one teaspoonful of the wine or 20 drops of 
the syrup of ipecac may be given every two hours until 
vomiting occurs, or a little alum mixed with honey or 
molasses and given in teaspoonful doses. A simple 
enema of soap and water to clean the bowel is always 
advisable. Goose oil or lard applied to the chest and 



314 PAINLESS CHILDBIRTH 

given internally in teaspoonful doses are popular in 
some parts of the country, but I have no confidence in 
them. Woolen cloths wrung out of an infusion of hops 
or hops and vinegar and applied to the chest as hot as 
can be borne are beneficial, and the inhalation of the 
hot steam from the same infusion is valuable. In the 
application of such means care should be exercised to 
prevent the cloths becoming cold and doing more harm 
than good. 

Physicians of the eclectic school rely on bloodroot 
and lobelia as an emetic in this disease and, though 
nauseous, I regard them as less dangerous than those 
already described. The acetic syrup of bloodroot and 
lobelia when it can be obtained is a remedy on which I 
place great reliance in croup. The following prescrip- 
tion can generally be obtained at any drug store, and 
answers the purpose well, if the real acetic syrup cannot 
be had : 



Tincture of Lobelia, . 


3 drams 


Tincture of Bloodroot, 


3 drams 


Simple Syrup, . 


1 ounce 


Vinegar, .... 


. 2 J4 ounces 



Dose — Fifteen drops to a teaspoonful repeated once in fifteen 
minutes till vomiting occurs. The dose must be varied accord- 
ing to the age of the child, the smaller dose generally being 
sufficient for those two or three years old. 

After vomiting, give it in smaller doses an hour or 
two apart, continuing the aconite at the same time, 
and increase the intervals between the doses as the 
symptoms become less severe. If necessary, it may be 
again pushed to cause vomiting in the same manner 
as before. Unpleasant as this medicine is, it is a very 
certain one, relaxing the spasm of the larynx, reliev- 
ing the suffocation, removing the accumulations of 



DISEASES OF CHILDREN 315 

mucus and materially aiding in overcoming the inflam- 
matory symptoms. 

The avoidance of colds, regular bowels, plain, easily 
digested food, especially for supper, and a properly 
ventilated bedroom will do much to prevent further 
attacks of croup. If the child is a " mouth breather" 
the tonsils and adenoids if enlarged should be removed. 

Membraneous or true croup is diphtheria of the 
larynx, and under that heading its symptoms and treat- 
ment will be given. 

ADENOIDS 

These are masses of enlarged lymphoid tissue in the 
upper part of the throat (vault of the pharynx, naso- 
pharynx) directly back of the posterior openings of 




Figure 80 

the nose. They are very common in children between 
the ages of six and ten, especially in damp, changeable 
climates. 



316 PAINLESS CHILDBIRTH 

Causes. — Heredity has an important influence in the 
production of adenoids. Frequent colds, measles, 
diphtheria, scarlet fever, are frequently followed by a 
catarrhal inflammation of the throat that results in 
the formation of adenoids. 

Symptoms. — Constant discharge from the nose, fre- 
quent colds in the head, restlessness at night, noisy 
sleep or snoring, night terrors, thick speech, are almost 
always present. Owing to the obstruction to free respi- 
ration, the child is compelled to breathe day and night 
through the mouth (mouth breather). In some cases 
the bridge of the nose becomes depressed, the lips thick, 
the edge of the nostrils sore. Ear-ache, deafness and 
cough are common symptoms. Many children suffering 
from adenoids become anaemic, listless, apathetic, back- 
ward in school studies and do not want to play. 

Treatment. — The nose and throat should be kept 
clean by sprays, douches or gargles. For this purpose 
Serler's tablets that can be bought at any drug store 
may be used. Crush one tablet, dissolve in four table- 
spoonfuls of clean warm water and use as spray to 
nose and throat with atomizer. One part of listerine 
and seven parts of water will also act as an excellent 
cleansing agent. Such remedies, however, are only 
nose-cleaners and never cure either catarrh or ade- 
noids. The adenoids should be removed by a surgical 
operation, and when this is done carefully and thor- 
oughly by a physician who knows just how to do it 
the results are most pleasing. 

ACUTE BRONCHITIS 

This is an inflammation of the lining mucous mem- 
branes of the bronchi or tubes of the lung and is a very 
common ailment in children, especially in the early 



DISEASES OF CHILDREN 

Figure SI 



317 




Treachea (windpipe), heart, and lungs 
Figure 82 




The Left Ear 
A, vestibule; B. auditory canal; C, middle ear; D, semicircu- 
lar canals; E r cochlea; G, eustachian tube 



318 PAINLESS CHILDBIRTH 

spring months when high winds and sudden changes 
in temperature are so frequent. Taking cold, insuffi- 
cient clothing or getting the feet wet are the usual 

Figure 33 




The Heart and Blood Vessels 

1, right auricle; 2, left auricle; 3, right ventricle; 4, left ventri- 
cle; 5, aorta; 6, the arch of the aorta; 7, descending aorta; 8, 
rigid subclavian vein; 9, left subclavian vein; 10, descending 
vena cava; 11, ascending vena cava; 13, innominate artery; 
14, right carotid artery; 15, right subclavian artery; 16, left 
carotid; 17, left subclavian; 18, pulmonary artery dividing 
into two branches, of which one, 19, goes to right lung and the 
other, 20, to the left; 21 and 22, pulmonary veins. 



DISEASES OF CHILDREN 319 

causes, but the disease may also occur as a complica- 
tion of whooping cough, measles, diphtheria and many 
contagious diseases. 

Symptoms. — The disease is often preceded by snuffles, 
running at the nose, sore throat or hoarseness. Fever, 
cough, rapid breathing and soreness and tight feeling 
in the chest show that the inflammation has extended 
to the tubes of the lung (pulmonary bronchi) . The fever 
is not high, but the child's respiration may be 40 to 
50 per minute. The cough at first is dry and tight, 
but later becomes loose; the sputum is swallov/ed and 
often causes vomiting. A child under four does not 
expectorate. Rattling or wheezing sounds in the chest 
are frequently heard. Loss of appetite and restlessness 
often exist. In the very severe types, the breathing 
becomes more rapid, the pulse weaker, the skin clammy, 
there is great prostration and the child falls into a deep 
stupor or convulsions end the struggle. 

Treatment. — Keep the child in bed in a well venti- 
lated room free from draughts. Give a laxative dose 
of castor oil at once or, if the taste of the oil be objec- 
tionable, a tablet containing one tenth of a grain of 
calomel every half hour for five or ten doses. The food 
should be liquid, soft or semi-solid, given in small 
quantities regularly every three hours, and hot drinks 
and hot mustard foot baths may be given, hot fomen- 
tations or poultices applied to the chest, but an oiled 
silk jacket worn during the whole attack of illness is 
preferable. The jacket is made like a vest and con- 
sists of three layers — an inner one of cheesecloth or 
light flannel, a middle one of half an inch of cotton 
batting, an outer one of oiled silk. When the cough is 
very tight a mustard paste made by mixing one part 



320 PAINLESS CHILDBIRTH 

of mustard with from four to six parts of flour or corn 
meal in some lukewarm water and spread between two 
layers of muslin or soft linen and large enough to en- 
velop the child's whole chest may be applied two or 
three times daily for a few minutes (usually about five), 
until the skin is slightly reddened. After removing 
the plaster, the skin is powdered and the jacket again 
put on. 

Rubbing the chest with camphorated oil will often 
give relief. 

Inhaling the steam from one pint of boiling water 
to which one teaspoonful of compound tincture of 
benzoin is added will often soothe the inflamed air 
passages. In young children the air may be moistened 
by allowing steam to pass from the tube of an Arnold 
sterilizer, or tea kettle through one side of a canopy 
placed over the bed. 

In the first stage give: 

Tincture of Aconite, ... 20 drops 
Wine of Ipecac, ... 1 dram 

Sweet Spirits of Nitre, . . 2 drams 

Simple Syrup, to make . . 2 ounces 

Directions — One teaspoonful in a little water every two or three 
hours. 

In the second stage when the secretion becomes thick 
and viscid, ropy or lumpy, and is coughed up only after 
considerable effort, especialty in the morning, give: 

Chloride of Ammonium, . . 1 scruple 

Compound Licorice Mixture, . 2 ounces 
Dose for a child five years old — One half teaspoonful in water 
every four hours. 

PLEURISY 

An inflammation of the serous membrane covering 
the lungs is called pleurisy. It is by no means common 



DISEASES OF CHILDREN 321 

in children, and when it does occur is usually as a 
complication of some other disease, such as pneumonia, 
scarlet fever, measles, typhoid fever, tuberculosis of 
the lungs, influenza, rheumatism. 

There are two kinds : (a) Dry pleurisy, (b) Pleurisy 
with effusion of serous fluid into the pleural cavity. 
When this fluid changes into pus the disease is called 
empyema. 

Symptoms. — Sharp localized pain or "stitch" in the 
side, short, dry, teasing cough, shortness of breath; 
child usually lies on the affected side, spaces between 
ribs are bulging, fever about 101°-103° F. Unless the 
case becomes an empyema, the disease rarely lasts 
longer than ten days. 

Treatment. — Put the child to bed, open bowels 
freely, apply poultices, fomentations or mustard plas- 
ters to painful part of chest. A flannel band around 
the chest sometimes relieves the pain. If the urine is 
diminished give from 1 to 5 grains of citrate of potash 
every 4 hours according to age. When the fluid in the 
pleural cavity is excessive, the physician will remove it 
by aspiration or other operation. 

PNEUMONIA 

This affection, also known as inflammation of the 
lungs , lung fever j winter fever, etc., is an acute inflamma- 
tion of the substance of the lungs, of frequent occur- 
rence and serious in its results. Its fatality, however, 
has been materially diminished by the improved 
methods of practice of late years. 

When the disease is confined to a circumscribed por- 
tion of the lung, it is termed lobular pneumonia; when 
only one lung is affected, single pneumonia; when both 



322 PAINLESS CHILDBIRTH 

lungs are involved, double pnuemonia; if pleurisy ex- 
ists in connection, pleuro-pneumonia; and when a 
typhoid condition is developed during its course, 
typhoid-pneumonia. 

In the majority of cases it is caused by cold, but those 
who have been debilitated by previous diseases, intem- 
perance, faulty nutrition, etc., from any cause, are 
specially liable. 

Symptoms. — For a day or two there is languor, 
dullness, a feeling of oppression in the chest, short 
cough, chilliness, etc., similar to a common cold. These 
symptoms may not attract any attention for a day or 
two when the advent of the disease will be marked by 
a pretty distinct chill, often resembling that of malarial 
fever. In children the chill is often replaced by convul- 
sions. This is succeeded by fever, pressure in the chest, 
which often increases to a constant pain that is aggra- 
vated by an annoying, short, dry and distressing cough. 
The pulse becomes frequent, the skin is hot and dry, 
the face flushed, the eyes red; there is severe pain in 
the head and back, the appetite is lost, the tongue 
is covered with a whitish coat, the bowels constipated 
and the urine scanty and highly colored, usually de- 
positing a branlike sediment on cooling. As the disease 
advances, respiration becomes shorter and more diffi- 
cult, the nostrils are dilated and the chest and shoul- 
ders elevated with every effort at inspiration. Delirium 
is often present. 

At first the cough brings up a little frothy mucus, 
but later on the sputum becomes opaque, very sticky 
and tenacious and assumes a peculiar rusty color, which 
is the characteristic expectoration of pneumonia. 






DISEASES OF CHILDREN 323 

In mild or favorable cases, and those in which the 
disease yields to the treatment properly, the expectora- 
tion now becomes more free, the cough looser and less 
painful, the fever diminishes and the symptoms sub- 
side, so that in from seven to nine days from the attack 
convalescence is established. 

In the severer cases all these symptoms are increased. 
The delirium is constant, there is great prostration, 
picking at the bed clothes, and dirty accumulations 
are seen on the teeth. Expectoration may be profuse, 
purple, yellow or bloody, and the breathing greatly 
embarrassed. In fatal cases, the delirium passes into 
stupor, and death may occur from the second to the 
fourth week. Recovery, however, may take place by 
the gradual subsidence of the symptoms, but a cough 
is apt to remain, or other diseases of the lungs, as hepati- 
zation, hemorrhage or consumption develop. 

The diagnosis of inflammation of the lungs in chil- 
dren is not always easy until the disease is well ad- 
vanced, although physicians by the aid of auscultation 
and percussion are able to distinguish it when the other 
symptoms are unreliable. To the unprofessional these 
aids are not available. Bronchitis and pleurisy so much 
resemble pneumonia that it is often difficult to dis- 
tinguish between them, but this is not so important to 
the general reader, for the treatment, particularly in 
the early stages, is almost the same. 

Treatment — The disease usually subsides about the 
seventh or ninth day, and during the whole course of 
the disease the little patient should be kept perfectly 
quiet in bed in a large, airy, well ventilated room. If 
we recognize the disease early and are successful in 
our efforts, we may cut it short or greatly modify its 



324 PAINLESS CHILDBIRTH 

severity and thus materially promote recovery. Give 
a hot mustard foot bath at once, with warm teas 
internally to promote perspiration, and then commence 
with the following: 

Tincture of Aconite, ... 40 drops 

Water, ..... 4 ounces 

Mix and give a teaspoonful every hour till the skin shows a 

disposition to moisten and the pulse becomes less frequent, then 

lengthen the interval to two or three hours, and thus continue it 

till the inflammation is subdued. 

If the difficulty of breathing is marked and the pain 
in the side severe, as in pleurisy, I would give in alter- 
nation to the foregoing: 

Tincture of Bryonia, . . 5 drops 

Water, ..... 4 ounces 
Dose — A teaspoonful every hour till relieved, and then it may 
be omitted. 

Open the bowels freely and apply hot poultices, hot 
fomentations or the oiled silk jacket described on page 
319. 

The scantiness of the urine may necessitate a reme- 
dy, when three to five grains of acetate of potash in a 
tablespoonful of water repeated three times a day will 
act nicely. This dose may be increased, if necessary, 
and for older children. 

Throughout the case give plenty to drink. Lemonade, 
acid fruits, jellies, water, milk, etc., are most agreeable. 

The diet should never be solid, but liquid or very 
soft. Milk, koumyss, beef tea, mutton broth, oyster 
soup, soft toast and, if there is much prostration, milk 
punch, eggnog, wine, etc., but care should be taken 
never to overstimulate. As improvement occurs, 
puddings, custard, scraped beef may be given, and 
still later a full, solid diet. 






DISEASES OF CHILDREN 325 

A warm alkaline sponge bath once or twice a day 
will materially promote comfort and recovery. Warm 
water containing a little common soda or saleratus is 
all that is necessary, care being taken, however, to pre- 
vent exposing the body when bathing lest a chill occur. 

During convalescence, tonics are called for — iron, 
quinine, hypophosphites, etc. The following is a good 
combination : 

Quinine, . . . . .10 grains 

Compound Syrup Hypophosphites, 2 ounces 
Dose — For a child one to two years old, one fourth to one half 
a teaspoonful three times a day. 

Sleep is encouraged by bathing at bed time, but if 
necessary, small doses of Dover's powders at night may 
be given. One or two grain doses are sufficient. 

The cough is sometimes very troublesome and may 
call for a special remedy, though in the milder cases 
the treatment already advised will be sufficient. When 
something of the kind is needed and in those cases 
where the cough continues after the inflammation has 
subsided give : 

Tincture of Bloodroot, . . 1 dram 

Tincture of Ipecac, ... 1 dram 

Compound Syrup Squills, . . 1 ounce 

Syrup of Wild Cherry, . . 2 ounces 

Dose — One half to one teaspoonful three or four times a day. 

When the cough is unusually severe and annoying, I add half an 

ounce of paregoric to the above; some, however, might prefer 

half a grain of morphine in place of the paregoric. This use 

of the opiate would of course overcome the necessity of the 

Dover's powder already mentioned. 

TUBERCULOSIS— CONSUMPTION 

Consumption is a serious constitutional malady 
characterized by a wasting of the body and attended 



326 PAINLESS CHILDBIRTH 

by an affection of the lungs, in which sooner or later 
tubercular deposits occur. No other disease is so wide- 
spread or fatal as consumption. It preys upon all classes 
of society and is the cause of about one seventh of all 
the deaths that occur in Europe and North America. 

It is much more prevalent among children than is 
usually supposed and is closely allied to scrofula. Some 
writers regard them as essentially the same, one being 
only a modified form of the other. 

The disease is characterized by feeble vitality, ema- 
ciation and loss of strength, sooner or later followed by 
a cough, expectoration, difficulty of breathing, fever, 
night sweats, hemorrhage and death. 

Consumption or tuberculosis is an infectious disease, 
and it has been definitely and positively proved that the 
actual cause is a germ called the Bacillus Tuberculosis, 
first described by Dr. Koch in 1881. The germs or 
bacilli are found in enormous numbers in the sputum 
or expectoration coughed up by those suffering from 
pulmonary tuberculosis or consumption of the lungs, 
and when this infected sputum is allowed to dry it 
enters the air as a fine dust, in this way spreading the 
disease in every direction and infecting houses, bed- 
rooms, furniture, carpets and clothing. 

The disease is most frequently contracted from breath- 
ing or inhaling air or dust containing the consumptive 
germs. It may, however, result from slight wounds 
or abrasions of the skin becoming inoculated with the 
germs, and tuberculosis of the intestines sometimes 
results from eating meat or milk from tubercular cows. 

Certain conditions of the system render it more 
favorable to infection. In from ten to fifty per cent 
of cases there is a family history of tuberculosis. It 



DISEASES OF CHILDREN 327 

very commonly occurs in weak, delicate, sickly people 
who have low vitality or deficient chest expansion. 
No age is exempt, but tuberculosis of the bones, in- 
testines and covering of the brain is more frequent in 
children than in adults. Depressing influences and any- 
thing that lowers the standard of vitality and lessens 
the resistance of the tissues favors infection. Thus, 
we find tuberculosis frequently following bronchitis, 
colds, pneumonia, pleurisy, measles, intestinal catarrh, 
fast life, exhaustive discharges, whooping cough, etc. 
Local injuries may so weaken the tissues that they are 
readily infected. Thus, for example, a simple inflamma- 
tion of a joint may become tubercular. 

While some of these causes do not apply to child- 
hood, I have introduced them here as a warning to 
the older ones into whose hands this book may chance 
to fall. Impairing the constitutions of the parents, they 
are, through hereditary transmission, indirect causes 
of consumption. 

In spite of the fearful mortality of this disease and 
the general belief that it is incurable, researches during 
the past twenty-five years prove conclusively that 
it can be cured. All modern writers are agreed upon 
this point. Numerous cases are on record where com- 
plete recoveries have been made, and many years after- 
ward the person has died from other diseases. Post 
mortem examinations have revealed many cases of the 
kind. 

The symptoms of consumption vary with the stage 
and progress of the disease. In most cases a general 
breaking down of the general health occurs for a longer 
or shorter time before the lung symptoms are developed. 
Whenever we find a growing weakness, paleness, loss 



328 PAINLESS CHILDBIRTH 

of flesh, quickened pulse, a little fever and shortness 
of breath coming on without any apparent cause we 
have just reason for anxiety. These are premonitory 
symptoms, and remedies will now be found most effi- 
cient. Soon a cough, generally hacking and worse at 
night, occurs. The patient says "I have taken cold and 
will soon be all right." Food does him no good; the 
cough becomes worse, expectoration more profuse. 
There may be a remission of all these symptoms and 
the victim think he is getting well, but another cold 
sets him back and develops the disease more severe 
than before, and fever and night sweats occur. Thus 
the disease goes on, alternating better and worse. 
Each time more severe and the recovery not quite so 
perfect. This may last for years, or it may complete 
its course in a few months. It is needless to trace the 
disease further; it is easily recognizable now, and its 
onward progress is marked with symptoms so plain 
that none need be longer deceived. 

In children, however, the symptoms of the lung 
disease are not always as well marked as in the adult, 
the deposition of that peculiar substance termed 
tubercle is apt to be more generally distributed through- 
out the abdominal and thoracic viscera. Consumptive 
children may waste away and die without the develop- 
ment of the lung symptoms when it receives the more 
technical name of tuberculosis. 

Treatment. — The most important consideration is 
the successful treatment, and the more thoroughly and 
persistently it is carried out the greater the chances of 
success. Any who have the slightest reason to believe 
that they are developing a consumption, or are in the 
least danger of doing so, should not rest until they have 



DISEASES OF CHILDREN 329 

marked out a course of hygienic and medical treat- 
ment. Do not wait a single day, time is precious. 
Your life depends on what you do now. Do not be 
put off by evasive answers. If you have not implicit 
confidence in your family physician's skill, consult 
some one else. Do not permit deference to old fogyism 
to rob you of life. Errors committed now will be over- 
come only with the greatest difficulty. 

We may indicate the general plan of treatment, but 
each individual is apt to present characteristics or 
modifications that will demand attention and perhaps 
require changes of remedies. It is too serious a disease 
to admit of unprofessional control, and yet there is 
time to select competent professional advice. I shall 
therefore beg the reader's pardon if I confine my remarks, 
mainly to the outlines of treatment, or to that part of 
it which the patients themselves or their friends must 
conduct for them. 

Take advantage if possible of climate, hygiene and 
medicine. As to climate, seek that which will enable 
you to live a greater portion of the time in the open 
air. No one climate is suitable for all tubercular 
patients. A dry, clear, pure air with an even tem- 
perature is best. Young people in the early stages of 
the disease usually do best in a cold, bracing climate 
like the Adirondacks, but those who are old or have 
the disease in an advanced form are, as a rule, better off 
in a warm, dry air like that of Southern California or 
Carolina. The very young, the very old and those in 
whom the disease is well advanced are better treated 
at home. 

Study the rules of hygiene and do everything that 
can contribute to health. Take plenty of good air, 



330 



PAINLESS CHILDBIRTH 



gentle exercise, but not enough to cause fatigue, nutri- 
tious food, and keep every organ in as nearly a healthy 
condition as possible. We must avoid every debili- 
tating influence. The disease breaks down. We must 
build up. 

It is folly to depend upon cough medicines for, as 
a rule, they only relieve one symptom at the expense 
of another; many of them ease the cough and destroy 
digestion. When employed they must be expected to 
benefit only the one symptom — cough. It must be 
understood that the cough in consumption is only a 
symptom of the disease, it is one of its branches as it 
were, and unless it is very troublesome is best left alone. 

Pain in the chest is often relieved by mustard paste, 
poultices or painting with tincture of iodine. 

Details of this character should be presided over 
by a competent physician who will provide for such 
indications as they arise. 




Figure 34 

The sputum must be coughed or spat into a paper 
sputum cup (Fig. 34), that should be destroyed every 



DISEASES OF CHILDREN 331 

day by burning. If a porcelain or other cup is used, 
it should be half filled with a 2% solution of formal- 
dehyde or carbolic acid, constantly kept covered, 
emptied and boiled every day. Paper napkins or 
pieces of gauze or old linen are preferable to handker- 
chiefs. Kissing must not be allowed. The bedclothes 
and dishes used for eating and drinking by a person 
with tuberculosis should be frequently boiled and disin- 
fected. 

A person with tuberculosis should when possible 
remain out of doors all day, and at night sleep alone 
in a room with all the windows wide open and the bed 
so placed that he will get the full benefit of the incom- 
ing air, but at the same time be protected from draughts. 
Sleeping in a tent or on a partly enclosed veranda is 
excellent. A window bed for tubercular patients is 
sold by many dealers 

The diet should be simple, wholesome and abundant. 
Milk, cream and eggs should be taken freely, but fresh 
meats, fresh fish, vegetables, cereals and fruits may also 
be used. Fats will do good if the patient can eat and 
digest them, but sweets, dainties, highly seasoned and 
rich foods should be avoided. Scraped beef, raw or 
slightly browned in the oven, is tasty and beneficial. 
Ale, porter or light wines may be used in moderation. 
When milk and cream are not well borne by the stom- 
ach, cod liver oil in as large doses as the patient will 
tolerate should be taken. 

Flannels should be worn at all times and the clothing 
must be warm and adapted to furnish protection 
against atmospheric vicissitudes. Avoid crowded 
schools, excessive study and sedentary habits. Adenoids 



332 PAINLESS CHILDBIRTH 

and enlarged tonsils should be removed to allow full 
and easy breathing. 

Bedrooms and living rooms occupied by persons with 
tuberculosis must be thoroughly fumigated and disin- 
fected before they are used by others. 

ASTHMA 

This disease is a spasmodic affection of the lungs 
which comes on in paroxysms, generally at night, and 
is attended by difficult respiration, short, dry cough, 
tightness across the chest, a wheezing noise, inability 
to lie down, etc. These symptoms may continue for 
several hours at a time and the attacks may occur 
very frequently or be separated by intervals of weeks 
or months. Repeated attacks often develop pulmonary 
disease. 

Although asthma is not usually seen before puberty, 
I have met with several cases among small children. 
When once developed it is apt to reappear at irregular 
intervals during the lifetime of the patient. 

The symptoms are too familiar to require any de- 
scription. 

The causes are obscure and varied. That which 
brings on an attack in one subject may have no influ- 
ence whatever on another. Atmospheric vicissitudes, 
overloaded stomach, inhalation of dust, certain odors, 
etc., may bring on an attack, and nasal catarrh, ade- 
noids and enlarged tonsils are frequent exciting causes. 
Some persons will be entirely free from it while in cer- 
tain localities, and be attacked again as soon as they 
depart. I know one man who would be entirely free 
from the disease while he remained at home in Saratoga 
Springs, but if he went even ten miles from home, 
he would be sure to have an attack, and if during the 






DISEASES OF CHILDREN 333 

attack he returned home, when within a mile or two 
of home would experience perfect relief. 

The treatment is empirical. Remedies without 
number have been advocated to be tried and discarded. 
Change of climate is often serviceable, but no climate 
will furnish immunity for all, or even a majority. The 
climate which one asthmatic finds beneficial will be 
of no advantage to another. 

During the late war I knew several soldiers who 
were entirely free from it while in Virginia, but the 
disease returned on coming home. 

If I had an asthmatic child I would seriously con- 
sider a change of climate for its benefit, and would 
expect to have to go a long distance to get the greatest 
benefit by the removal. 

Chronic bronchitis and nasal catarrh, co-existing 
with asthma will be likely to defeat any plan of treat- 
ment that does not consider their cure. I have seen the 
asthma yield readily after these complications had been 
overcome. Any plan of treatment should include the 
correction of all co-existing diseases. 

Adenoids and enlarged tonsils should be removed. 
When the attack is caused by an overloaded stomach 
or indigestion, an emetic should be given. 

Temporary relief may almost always be afforded 
by inhaling the fumes from burning niter, and stram- 
monium, or belladonna leaves. Mix one fourth pound 
of coarse powdered strammonium leaves and one pound 
of nitre, burn a tablespoonful of the mixture and in- 
hale the smoke; repeat if necessary. This may be varied 
by using half strammonium and half belladonna leaves 
to the same proportion of nitre. Blotting paper soaked 
in a strong solution of nitre, dried and burned, is also 



334 PAINLESS CHILDBIRTH 

effective. These substances furnish the basis for all 
the cigarettes, smokes, pastiles, etc., now in use. 

The California plant grindelia, combined with other 
remedies to suit the peculiarities or complications of 
the different cases, has proved beneficial in many in- 
stances. The following will usually afford temporary 
relief: 



Tincture of Bloodroot, 


34 ounce 


Tincture of Lobelia, . 


}/2 ounce 


Bromide of Potash, . 


}/2 ounce 


Simple Elixir, . 


to make 4 ounces 



Mix. Dose — For an adult a teaspoonful every half hour or 
hour till relieved or nausea is produced. Smaller doses for chil- 
dren. This is an excellent though nauseous remedy. Some find 
pretty large doses of quinine capable of cutting short an attack # 

Attention to the bowels is necessary. A cathartic 
dose of podophyllin or a compound podophyllin pill 
taken at the commencement will often modify an attack. 

Measures for a permanent cure, if undertaken, must 
be persevered with for a considerable length of time, 
and are to be continued during the intervals as well as 
during an attack. 

WHOOPING COUGH 

This is a disease peculiar to childhood, but is some- 
times witnessed in adults. It is contagious and prevails 
as an epidemic, uninfluenced in its occurrence by season; 
rarely attacking an individual more than once, which 
is generally the first time they are exposed to its causa- 
tive influence, though cases are known where it has 
reappeared a second and even a third time. 

It is due to a specific poison which appears to be 
communicated directly from one child to another, yet 
it is presumed that some peculiar atmospheric condi- 
tion is favorable to its propagation and is the principal 



DISEASES OF CHILDREN 335 

means by which it is spread. Be this as it may, there 
is plenty of evidence for and against this theory, but, 
as no good can well result to the nonprofessional reader 
from its discussion, it will be omitted. 

It generally runs a regular course, lasting from six 
to ten weeks, and were it not for the complications 
liable to develop during its course would seldom or 
never prove fatal. Spasmodic cough, bronchitis, etc., 
often continue for a long time after the specific disease 
has run its course. 

Whooping cough is essentially a nervous disease, 
usually milder in warm than iu cold climates and is 
less severe when it occurs during warm weather. 

Symptoms. — The disease may be divided into three 
stages: the catarrhal, the spasmodic or paroxysmal, 
and the stage of decline. 

The first or catarrhal stage is very similar to an ordi- 
nary cold, accompanied by slight fever, languor, loss 
of appetite and restlessness with more or less cough. 
Sometimes these symptoms are severe and in other 
cases pass unnoticed. 

After a week or two, the second or spasmodic stage 
appears. The fever abates, and the cough which has 
gradually developed becomes peculiar, persistent, spas- 
modic and characterized by a loud, shrill inspiration 
or whoop which gives the disease its name. The cough 
comes on in paroxysms, varying in frequency from once 
or twice a day to as many times an hour. When a fit 
of coughing comes on, the child instinctively grasps 
something for support or runs to its mother for protec- 
tion, but returns to its play when the paroxysm is 



336 PAINLESS CHILDBIRTH 

ended. During the paroxysm, which may last from a 
few seconds to several minutes, there is a rapid 
succession of short, spasmodic coughs, succeeded by 
the prolonged inspiration or whoop, during which the 
face becomes red, turgid and bloated, the blood vessels 
distended and the eyes prominent. The paroxysm 
often terminates in vomiting or the expulsion of a 
thick tenacious mucus. 

This vomiting may be so serious as to materially 
interfere with nutrition, by causing the child to vomit 
so soon after eating as to prevent the digestion and 
assimilation of its food. 

This stage — the spasmodic — lasts from three to 
eight weeks, when it gradually subsides, passes into 
the third stage — decline — and terminates in recovery, 
unless some serious complication, such as pneumonia, 
hemorrhage, convulsions or diarrhoea has been devel- 
oped. 

In the first stage the expectoration is a frothy mucus. 
In the second it is transparent, yellowish, possibly 
purulent, ropy and tenacious. In the third it becomes 
less tenacious, slightly opaque, diminishes in quantity 
and disappears. 

Sometimes this expectoration is so ropy it cannot 
be drawn out of the child's mouth with the fingers. 
When it is so very tenacious and in feeble children 
they may be aided by grasping it with the corner of 
a napkin and drawing it from the mouth and air pas- 
sages. 

Treatment. — It is questionable if treatment ever 
does more in whooping cough than to palliate and 



DISEASES OF CHILDREN 337 

modify the symptoms and prevent or control compli- 
cations. Unless it is prevailing in the neighborhood 
as an epidemic, it will be impossible to distinguish the 
first stage from other catarrhal affections. When sus- 
pected give: 

Tincture of Aconite, ... 5 drops 

Tincture of Belladonna, ... 5 drops 

Water, ..... 4 ounces 

Dose — A teaspoonful every hour or two. If the cough is har- 

rassing, add to the foregoing prescription half a dram of the 

tincture of drosera and give in the same way as before. 

Keep the child with whooping cough away from 
school, and from other children and in a room where 
the air is pure and the temperature even. Give light, 
nourishing food and keep bowels regular. Keep chest 
anointed with camphorated oil. A strong tea or infu- 
sion of chestnut leaves sweetened to the taste and given 
in doses of one or two tablespoonfuls five or six times 
a day sometimes exerts a wonderful control over the 
disease in the first and second stages. The earlier it is 
given the better. If the leaves cannot be obtained, 
the fluid extract which can be got at nearly all drug 
stores may be given in five or ten-drop doses in water 
and repeated as often as the infusion. 

A tea of red clover blossoms has long been favorably 
known in rural districts and may be given freely, 
sweetened or not. Sometimes it will cause looseness 
of the bowels. I have seen it control other forms of 
spasmodic cough very promptly. 

If the child vomits soon after eating, it should be 
given another meal. In infants the milk should be well 
diluted. 



338 PAINLESS CHILDBIRTH 

The wearing of an abdominal binder seems to check 
the vomiting in many cases. The following remedy 
often proves helpful: 

Fluid Extract of Belladonna, . 5 drops 

Fluid Extract of Lobelia, . . 30 drops 

Water, ..... 4 ounces 

Given in teaspoonful doses every hour or two to children 

under five years will often afford decided relief from the spasmodic 

efforts. If taken too freely it causes vomiting, and is therefore 

objectionable to some. 

Antipyrin and codeine prescribed by the physician 
in doses suitable to the age of the child are excellent 
remedies. 

The following is an old fashioned remedy that often 
answers well when others fail: 

Cochineal, ... . . 10 grains 

Bicarbonate of Potass, . . 1 dram 

Fluid Extract of Belladonna, . 10 drops 
Syrup, ..... 4 ounces 
Dose — A teaspoonful three or four times a day. 
It has been my experience that remedies that relieve 
very effectually, some years, have very little influence 
in others. I do not pretend to explain this observation. 
I have found the following very efficient during two 
epidemics occurring in the fall and winter: 

Bromide of Potash, ... 2 drams 

Fluid Extract of Veratrum, . 10 drops 

Fluid Extract of Black Cohosh, . 1 dram 

Syrup, . . . . 4 ounces 

Mix and give a teaspoonful four times a day. It speedily 

modifies the spasms, controls the bronchitis and relieves all the 

symptoms. Belladonna in equal proportions may be substituted 

for the veratrum if relief is not obtained in two or three days. 

This may be given at the same time the infusion of chestnut 

leaves is employed, giving the doses an hour or two apart. 



DISEASES OF CHILDREN 



339 



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340 PAINLESS CHILDBIRTH 

Two or three days is usually long enough to deter- 
mine whether a remedy is going to do good or not and, 
if no improvement is apparent in that time, something 
else may be tried. 

If there is decided determination of blood to the 
head, the head hot, with dizziness, extreme suffocation, 
the expectoration stringy and profuse, I would use the 
last named prescription with a good deal of confidence 

MUMPS 

This is an inflammation of the parotid glands, 
situated just under the ear, hence the name parotitis. 
The salivary glands under the jaw are also at times 
affected. It is a contagious disease and usually occurs 
in childhood, and when both sides have been affected 
it rarely returns. We often see cases where only one 
side has been affected. In these cases, perhaps years 
afterwards, the individual may have another attack 
which will be confined to the opposite side. It usually 
occurs as an epidemic and appears in from five to 
twenty days after the exposure. Children under three 
years of age are rarely affected. 

Symptoms. — There is more or less febrile disturb- 
ance, chilliness and sometimes vomiting, followed in 
from twelve to thirty-six hours by a pain under the 
corner of the jaw, sometimes extending into the ears. 
Soon after the advent of the pain a swelling begins that 
sometimes attains an enormous size. This swelling gen- 
erally reaches its greatest size on the fourth or fith day, 
when it remains stationary for a day or two and gradu- 
ally declines, so that by the twelfth day it has entirely 
disappeared. It may involve both sides simultaneous- 
ly, or may disappear on one side first and, about the time 
of its disappearance on this side, attack the other. 



DISEASES OF CHILDREN 341 

An old fashioned domestic diagnostic symptom that 
appears to be ignored by the profession was to have 
the suspected individual eat a pickle or some acid 
substance when, if it caused severe twinges of pain 
running into the swollen gland, it was pronounced 
mumps without any further ado. 

A peculiarity of this disease is that the inflammation 
is liable to suddenly disappear from the neck and ap- 
pear in the testicles of the male or the breasts or ovaries 
of the female, more especially if the afflicted person 
" catches cold" duringthe progress of the malady. Seri- 
ous consequences, amounting to impotence or sterility, 
sometimes occur by this metastasis, as it is termed. 

Treatment. — We have no remedies that do more 
than modify the severity of the disease, and many 
persons, particularly when the attack is mild, do nothing 
at all further than to remain indoors and, perhaps, 
take a few extra precautions against taking cold. 

The food should be liquid and the mouth frequently 
cleansed with an antiseptic mouth wash (one teaspoon- 
ful of listerine in half a glass of water) . A mild laxative 
may be given if the bowels are sluggish. Apply hot 
fomentations or poultices to the neck. A poultice of 
common beans cooked till nearly done, bruised and 
applied is excellent, or the swollen gland may be 
smeared with camphor liniment and covered with 
flannel. If the febrile symptoms are severe, give: 

Tincture of Aconite, . . .10 drops 

Water, ..... 4 ounces 

Dose — A teaspoonful every hour or two. If the swelling is 

severe, add to the aconite and water half a dram of the saturated 

tincture or fluid extract of poke root (phytolacca decandra) and 

take it as before. 



342 PAINLESS CHILDBIRTH 

Aconite is the remedy, and if properly pushed and 
proper care exercised to guard against cold it is rare 
that suppuration or metastasis to other glands will 
occur. 

Should it disappear from the neck suddenly, and 
attack those other parts mentioned, keep on with the 
aconite and Phytolacca and also give in alternation: 






Tincture Pulsatilla, . . .15 drops 

Tincture Gelseminum, . . 30 drops 

Water, ..... 4 ounces 

Dose — A teaspoonful every two to four hours between the 

doses of the other. Apply to the swollen parts, as warm as it 

can be borne, a solution of muriate of ammonia in water, an 

ounce in a pint of water. 

Rest in the recumbent position under such circum- 
stances should always be enjoined, and the swollen parts 
carefully supported instead of being permitted to hang 
down. 

To secure rest and if the pain is severe a dose of 
Dover's powder proportioned to the age of the patient 
should be given. 

When the gland suppurates it should be opened by 
the physician. This will be better than to endure the 
pain and suffering for many days, waiting for the. 
forming abscess to break itself. 

Every case of mumps should be isolated or quaran- 
tined for at least three weeks. 

SORE THROAT 

This is a very common complaint and we meet with 
numerous cases that do not admit of the customary 
classifications; as they are neither diphtheria nor quinsy 
they are too often ignored. 



DISEASES OF CHILDREN 343 

We might perhaps satisfy sticklers for names if we 
include all these cases under the one general classi- 
fication — pharyngitis, but, after all, it is "sore throat. " 
Sore throat is often an accompaniment of other diseases. 

There are several varieties of the affection depend- 
ing for the most part upon atmospheric conditions 
resulting in colds as the exciting cause. The predis- 
posing causes are catarrh of the head and throat, im- 
paired constitutional vigor, venereal taint, and many 
persons acquire a habit of having a sore throat on ex- 
posure to cold, damp, changeable weather, etc. Diphthe- 
ria, quinsy, laryngitis, etc., often leave behind them a 
tendency to sore throat. When a person has once 
suffered from a severe sore throat, future attacks are 
to be feared. 

Chronic sore throat is very prevalent. 

Symptoms. — The symptoms vary according to the 
cause and peculiarities of the patient. The throat 
is tender, inflamed and sometimes ulcerates. During 
an inflammatory attack there is chills and fevers, 
hoarseness, a desire to swallow often or clear the throat, 
the mucus membrane may be bathed in a profuse glairy 
mucus or it may be dry, irritable and husky. The 
natural color may be changed to an intense red, vary- 
ing to a dusky or livid. The whole pharynx may be 
swollen, and if there is a tendency to ulceration the 
breath becomes exceedingly offensive, and examina- 
tion reveals small ulcers or cankers which may run 
together and produce extensive sores. 

Usually these sore throats are very annoying, and 
when neglected are apt to become chronic, and by ex- 
tension downward along the mucus membrane into 



344 



PAINLESS CHILDBIRTH 



the lungs or stomach are apt to give rise to serious 
consequences. 

The treatment must be varied to suit the conditions 
that present. If of the inflammatory variety, the throat 
red and swollen, pulse accelerated and there are general 




Figure 86 

febrile symptoms, aconite is pre-eminently the remedy, :> 
whether the patient is a child or an adult. It may be 
given in combination with belladonna. Put five drops 
of each in half a goblet of water and take a teaspoonful 
every hour. 

Then give chlorate of potash as a gargle and permit a 
little of it to be swallowed every three hours. A teaspoon- 
ful of the crystals in half a goblet of water is about the 



DISEASES OF CHILDREN 345 

proper strength. The compressed tablets of chlorate 
of potash which can be got at any drug store are more 
convenient, as they can be carried in the vest pocket 
and dissolved in the mouth and swallowed slowly as 
they dissolve. The dose for children may be one fourth 
to one half a tablet, or two or three grains every two 
or three hours. 

If the breath is offensive, give a grain or two of the 
second trituration of the red iodide of mercury, or pink 
powder as it is often called. It comes the nearest to 
being a specific in the majority of cases of " sore throat " 
yet discovered and is specially valuable when the breath 
is offensive, though, if there is inflammation, never 
omit the aconite. 

Those subject to an attack of sore throat with every 
change of weather should carry a vial of aconite pellets 
and a box of tablets with them for use at once. 

These remedies are always appropriate even in those 
cases where the predisposing cause is catarrh or syphi- 
lis, but a complete course of treatment to completely 
overcome these constitutional affections must be insti- 
tuted in the interval, depending only on the remedies 
above named for the relief of acute symptoms. 

Sprays are better than gargles and the following 
will be found excellent when the throat is cankered 
or ulcerated: 

Peroxide of Hydrogen, . . 2 ounces 

Aqueous Extract of Witch Hazel, 2 ounces 
Cinnamon Water, ... 2 ounces 
Directions — Use as spray to throat every two hours by means 
of an atomizer. 

Wet packs about the neck, gargling the throat with 
very hot water or equal parts of hot milk and water 



346 PAINLESS CHILDBIRTH 

facilitate the cure, but of course are to be used only 
when the patient remains indoors. Frequent bathing 
the neck with cold water or whisky and water on the 
outside is beneficial in overcoming the sore throat habit. 
In chronic sore throat there is generally an impaired 
condition of the general health that demands aid for 
the reparative powers of nature by appropriate reme- 
dies as well as the employment of medicines for the 
local symptoms. 

QUINSY 

Quinsy or tonsilitis is, as the name indicates, an acute 
inflammation of the tonsils, implicating the uvula, soft 
palate and throat generally. One or both tonsils may 
be affected at the same time. It sometimes terminates 
in suppuration, requiring to be opened with the knife, 
or perhaps breaks and discharges the matter itself. 

The causes are cold, change of temperature, damp, 
wet feet and all the usual causes of colds. Rheumatic 
persons are most liable to it. 

Symptoms. — At first there is a soreness or stiffness 
of the throat, with heat and often pain. There may be 
chills which will be succeeded by fever. The throat is 
dry, hot and swollen and swallowing becomes difficult 
and every attempt is attended by excruciating pain. 

The uvula is enlarged and elongated; the end drop- 
ping down into the throat occasions a sensation as if 
some foreign substance was lodged in the throat, caus- 
ing frequent attempts at swallowing and giving rise 
to much irritation. 

On examination, one or both tonsils are seen to be 
swollen, the uvula elongated and the whole throat un- 
naturally red and shiny. The pulse is rapid, the tongue 



DISEASES OF CHILDREN 347 

furred and the bowels usually constipated. The pain 
from the inflamed tonsils often extends into the ears. 

As the disease advances, the difficulty in swallowing 
increases to such an extent sometimes that on attempt- 
ing to swallow fluids they are expelled through the nose. 
The speech becomes indistinct and the thirst is great. 
These symptoms all vary in severity. 

The symptoms described may continue from five to 
twenty days, and may gradually subside, or they may 
terminate in suppuration of the affected tonsil. The 
formation of matter is indicated by a throbbing pain, 
sometimes accompanied by a chill. This throbbing 
continues until the swollen gland is opened or breaks 
itself and a free discharge of matter takes place, when 
the swelling is suddenly reduced and all the symptoms 
subside and rapid recovery takes place. 

Sometimes during the disease the tonsils are covered 
with little ulcerated patches and may be mistaken for 
diphtheria. Sloughing may take place, particularly 
in those whose constitutions are previously much 
impaired. 

Both children and adults are subject to the disease. 

Treatment. — One of the first remedies to be thought 
of is aconite, five drops in half a goblet of water and a 
teaspoonful given every hour. It may be combined 
with Phytolacca with benefit, thus: 

Tincture Aconite, ... 5 drops 

Fluid Extract Phytolacca, . . 15 drops 

Water, ..... 4 ounces 
Dose — A teaspoonful every hour or two. 



348 PAINLESS CHILDBIRTH 

If this prescription is given at the outset, it will be 
likely to cut short the disease. Alternate it with: 

Tincture of Hyoscyamus, . 30 drops 

Water, ..... 4 ounces 

Dose — A teaspoonful every two to four hours, between the 
doses of aconite. Larger doses for adults. 

I do not remember ever having seen hyoscyamus 
recommended in quinsy, but I have used it in a number 
of cases with most gratifying results. 

A cathartic is always demanded. A seidlitz powder 
or a dose of salts may be given or, what is better, podo- 
phyllin and leptandrin, one tenth of a grain each for 
a child, one half grain each for an adult and repeat in 
twelve hours if needed; let it be taken at night, as a 
rule, the saline in the morning. 

If the pain is so severe as to prevent sleep, a small 
dose of Dover's powder may be taken at bedtime. 
An ice bag or hot poultices applied to the neck are bene- 
ficial and inhaling the vapor from an infusion of hops and 
vinegar sometimes affords marked relief. The peroxide 
of hydrogen spray mentioned on page 345 will be found 
very helpful. Small pieces of ice to suck may be given. 
The food should be liquid and not too hot. Anti- 
rheumatic remedies, salicylate of sodium or aspirin 
should be given to those who are rheumatic. 

Frequent attacks are liable to result in a permanent 
enlargement of the tonsils and give so much annoyance 
that an operation for their removal becomes necessary. 

DIPHTHERIA 

Diphtheria is an exceedingly grave malady in which 
we have a profound constitutional disturbance accom- 
panied by a severe affection of the throat, characterized 



DISEASES OF CHILDREN 349 

by the development of patches of false membrane de- 
veloped more or less extensively on the mucous mem- 
branes of the throat and air passages. 

The cause of diphtheria is a germ — the Bacillus 
Diptherise. It is a contagious and infectious disease, 
and often prevails as an epidemic, though isolated 
cases are occasionally seen. As a- result of over- 
crowding, it is more common among the poor. 

Diphtheria is no respecter of person, age, condition, 
rank or temperament. Whole families are sometimes 
destroyed, although children under ten years furnish 
the greater percentage of its victims. 

The symptoms vary in different cases from a mild 
sore throat to the most serious and malignant blood 
poisoning. Between these extremes we meet with every 
grade of intensity. The exudation of " false membrane" 
is the most certain diagnostic sign. 

There may be premonitory symptoms, as languor, 
dullness, fretfulness, thirst and impaired appetite, but 
they are apt to pass umioticed. These may last two 
or three days, when there will be chilliness sometimes 
amounting to a severe chill, succeeded with feverish- 
ness, headache, backache and, in some cases, rheu- 
matic pains, with derangement of the skin, kidneys 
and bowels. 

There may be a stiffness of the neck, heat and irri- 
tation in the throat at the outset, but usually the throat 
is not complained of until the fever is developed. On 
examining the throat it will be found somewhat swollen, 
of a red or livid hue, at first covered with a glair}^ 
mucus, soon to be followed by ashen gray spots on 
the membrane, which are usually grouped together in 



350 PAINLESS CHILDBIRTH 

clusters, becoming more numerous as the disease ad- 
vances and, coalescing, extend over large surfaces, pre- 
senting the peculiar ashen gray wash-leather appear- 
ance characteristic of the disease. This peculiar exu- 
dation may take place upon the surface of any mucous 
membrane in the body. It frequently extends upward 
and lines the nasal cavity (nasal diphtheria) and down- 
ward into the larynx (laryngeal diphtheria or true croup) 
and trachea, seriously endangering life by suffocation, 
or it may extend downward along the esophagus into 
the stomach and bowels and has extended the whole 
length of the alimentary canal. 

There is more or less fever, usually typhoid in char- 
acter. The pulse varies from rapid and full at first to 
feeble; or it may be slow and feeble at the outset. 
The temperature is frequently very high. 

The saliva is thick and tenacious and difficult of 
removal, the breath offensive, the teeth become cov- 
ered with sordes and the lips black and parched. After 
two or three days the exudation is liable to become 
detached, leaving the surfaces beneath raw and ex- 
tremely sensitive, so that the attempts at swallowing 
or even breathing are exceedingly painful. The more 
extensive the patches of membrane are the greater the 
difficulty of detaching them will be, and as one edge 
becomes loosened before the rest it may be heard to 
flap back and forth with each respiration with a noise 
well calculated to occasion anxiety. The denuded 
surfaces may ulcerate, and foul, unhealthy sores re- 
place the " false membrane." 

In mild cases when the membrane has not yet been 
formed it may be mistaken for catarrhal sore throat, 
but in all such cases, particularly if diphtheria be 



DISEASES OF CHILDREN 351 

prevailing in the neighborhood, the great depression 
of the system is sufficient cause for alarm and suggest- 
ive of immediate action. 

In some cases an eruption has appeared upon the 
skin so nearly resembling scarlet fever that many have 
been led to regard the two diseases as identical. 

Sometimes in the beginning of the severer forms 
of the disease the patient will be attacked with vomit- 
ing of a yellowish watery fluid; this may be followed 
by a purging of a matter similar in character. After 
a painful restlessness the patient may sink into a stupor 
or unconsciousness, which may be again replaced with 
delirium and all the powers of life rapidly fail. 

In fatal cases death may occur from blood poison- 
ing, the patient gradually sinking, but more often it 
is occasioned by the sudden formation of heart clots. 
Suffocation is also a frequent form of death, when there 
will usually be a gradual decline, the patient becoming 
unconscious and comatose before the end, owing to 
the accumulation of carbonic acid in the blood. 

When the disease terminates favorably a marked 
improvement in all the symptoms generally takes place 
from the fifth to the tenth day. The swelling of the 
throat subsides and the patches of false membrane 
cease to re-form, as the different portions become loos- 
ened and are thrown off. The local discomfort grad- 
ually disappears and the general symptoms rapidly 
improve. The temperature permanently becomes 
natural, the appetite returns, the skin and kidneys 
resume their natural functions and, with the exception 
of the muscular weakness, the invalid feels quite well. 

The danger, however, is not yet entirely over, for 
relapses frequently occur, with a new formation of 



352 PAINLESS CHILDBIRTH 

false membrane and a return of the most serious symp- 
toms; or there may be a clot formed in the heart with 
a sudden failure of its action and death by fainting 
result; and even when there is an escape from these 
contingencies at a later period there may occur diphthe- 
retic paralysis. It is well, therefore, that the convales- 
cence be well guarded ' and care taken against all 
ordinary exertion and exposure for some little time 
after the symptoms have disappeared. 

LARYNGEAL DIPHTHERIA 

This variety of diphtheria is also known as mem- 
braneous or true croup and, as it is by far the most 
dangerous form of the disease, it is very important 
that it be recognized as early as possible and prompt 
measures taken to avert its consequences. As a rule, 
it comes on gradually and results from an extension 
or spreading of the diphtheretic process from the throat 
to the vocal cords. It is recognized by a persistent 
harsh, croupy cough, often occurring in paroxysms at 
any time of day or night; dry, stridulous whistling 
breathing, hoarseness or loss of voice. During the fits 
of coughing, tough gray pieces of membrane are often 
expelled. The face is pale and anxious, the breathing 
labored and there is retraction of the soft parts at the 
sides of the chest and above the breastbone. As the 
obstruction to breathing increases, the child becomes 
restless and tosses and struggles for air, the wings of 
the nose expand, the veins become distended, the lips 
and fingertips blue, the skin covered with cold sweat, 
the pulse weak and rapid, the extremities get cold and 
the child falls into a state of semi-stupor that steadily 
increases until death occurs. 



DISEASES OF CHILDREN 353 

Treatment. — It is folly to advise that the manage- 
ment of so grave a disease be undertaken without the 
attendance of a physician and, though such be the case, 
in view of the conflicting opinions, I will venture, to 
describe such treatment as has served me best. 

If possible, the patient should be put into a clean, 
dry, well aired bed in a good-sized, well ventilated 
room, stripped of all unnecessary furniture and dra- 
peries and a sheet put over the door. The room should 
be one that can be kept at a moderate temperature. 
Exclude everyone from the room not necessary for the 
care of the sick person and thus prevent as much as 
possible the spread of the malady. Disinfectants should 
be employed about the room and are not only benefi- 
cial to the patient, but afford a certain degree of pro- 
tection to the attendants. Chloride of lime may be 
used for the purpose, exposed in dishes and occasion- 
ally a little vinegar poured upon it. Under the direction 
of the physician a little sulphur may be burned in the 
room, care being taken that the sulphurous acid gas 
disengaged does not become so dense as to cause 
suffocation of the patient. 

We must maintain the vital powers by all the means 
at our command. Nutritious and stimulating food is 
necessary from the commencement — beef tea, mutton 
tea, milk, eggs, wine whey, milk punch, etc. If milk 
disagrees, the addition of a little lime water will usually 
overcome the objection. Repeat or alternate these 
articles so that every two or three hours some nourish- 
ment is given. 

As soon as diphtheria has been diagnosed, or even 
strongly suspected, the physician should administer a 
dose of antitoxin. The value of this agent has been 



354 PAINLESS CHILDBIRTH 

demonstrated and proved in so many thousands of 
cases that it should be given without delay, and re- 
peated if necessary. Every child that has been exposed 
to the disease should receive an immunizing or pro- 
tecting dose of antitoxin. 

The peroxide of hydrogen spray mentioned on page 
345 may be used every two hours with an atomizer. 

Small pieces of ice to suck will often prove grateful 
to the little patient. 

Infants with diphtheria should not nurse from the 
breast, but the milk should be pumped out and fed 
from a bottle. 

Fumigations of calomel may be ordered by the physi- 
cian. 

Stimulants are often needed. Infants under one 
year will need from one quarter to one half teaspoonful 
of whiskey in water every three hours; children over 
two years a teaspoonful at the same intervals. 

The child should be kept quiet on its back and not 
allowed to toss or struggle, as the extra exertion may 
prove too great for the heart. 

In laryngeal diphtheria, antitoxin should be adminis- 
tered, but should the obstruction to breathing increase, 
intubation or tracheotomy will be necessary. 

In nasal diphtheria the nasal cavities should be irri- 
gated with warm solution of salt (one teaspoonful of 
salt dissolved in one pint of water). 

CEREBROSPINAL MENINGITIS 

This exceedingly fatal disease is also called spotted 
fever and consists of an inflammation of the cerebro 
spinal meninges (the membranes covering the brain 
and spinal cord). It is infectious and usually occurs 
as an epidemic, prevailing as a rule in circumscribed 



DISEASES OF CHILDREN 355 

localities and does not seem to be retarded by the best 
sanitary regulations. The young and vigorous as well 
as the debilitated and infirm are among its victims. 
But little is known regarding its cause. 

Symptoms. — The symptoms vary according to the 
severity of the disease to such an extent that Stille 
has termed it the " chameleon-like disorder. " The 
attack commences abruptly with lassitude and muscu- 
lar pains, soon followed with a chill, intense headache, 
vomiting, dizziness and great prostration. There may 
be mental excitement amounting to delirium, but this 
gives way sooner or later to depression and a disposi- 
tion to sleep, or unconsciousness. At first, there is 
intolerance of light and sound to be replaced later on 
by insensibility to both. The greatest suffering is from 
the pain in the head and spine. A curious symptom is 
that when the patient is insensible a slight pinch or 
even the attempt to open the eyelids will call out an 
expression of pain. 

The muscles of the neck, back and extremities be- 
come painful and rigid, the head drawn backward and 
the back curved so that the body describes the arc of 
a circle. The face is pale and shrunken, the features 
pinched, indicative of great suffering. Muscular twitch- 
ings occur and, in some cases, general convulsions. 
The surface of the body is very sensitive to the touch, 
and a slight motion sometimes wall be sufficient to 
excite a spasm. When the finger is drawn over the 
skin a red line remains — the tache cerebrale. 

Some little time may be consumed with these symp- 
toms, so that the disease may not reach its height for 
three or four days, but in the severer forms of the mala- 
dy the patient is suddenly stricken down with a chill 



356 PAINLESS CHILDBIRTH 

and dies in a few hours without showing any signs of 
a reaction. In such cases the chill is speedily followed 
by a rapid sinking of all the vital powers, the skin 
becomes blue and cold, the blood settles in blotches 
under the skin in various parts of the body, perhaps 
oozes from the nose, gums, mouth and skin, and there 
is a short period of delirium followed by a stupor from 
which the patient never revives. 

So rapidly may the disease do its work that the char- 
acteristic bending backward may not occur, and I have 
seen cases in which the blood spots did not appear 
till after death. 

In mild cases, the muscular pains, headache, stiffness 
of the muscles, fever, etc., may be present two or three 
days and then gradually disappear without the develop- 
ment of the other symptoms. 

When recovery does take place, there may be a long 
period of great nervous irritability, feebleness, together 
with more or less perversion of all the faculties. 

Fatal relapses sometimes take place after several 
weeks of apparently satisfactory convalescence. 

Treatment. — Great diversity of opinion prevails 
in regard to the proper treatment of cerebro-spinal 
meningitis, and no suggestions I may offer should be 
permitted to take the place of professional attendance. 
The variable character of the attack necessitates the 
best judgment in the selection of remedies. In the 
severer cases, all our efforts seem powerless. 

FJexner's serum has robbed this disease of all its 
former terror and is to cerebro-spinal fever what anti- 
toxin is to diphtheria. The physician should inject the 
serum into the spinal canal as soon as the disease has 
been diagnosed. 



DISEASES OF CHILDREN 357 

The application of heat to the back of the neck and 
spine is a measure recommended by good authorities, 
and may be managed by cloths wrung out of hot water, 
or hot bottles of water. This should be frequently 
repeated and often gives decided relief. Ice bags 
applied to the spine usually feel more grateful and give 
better results. 

Attention to the bladder should not be forgotten. 
This organ is often paralyzed and will need measures 
for its relief. Heat placed over the lower abdomen 
will sometimes succeed, but, if it fails, a catheter must 
be used. 

Prostration must be combatted by stimulants, 
among which ammonia, capsicum and alcohol are at 
the head. But little can be said as to the dose. It must 
be governed by the effect and, while they do good or 
improve symptoms, they may be pushed, but many 
times they will produce but a transitory effect or no 
result at all. 

From the commencement, a good nutritious diet 
must be given. Beef essence, animal broths, eggs, milk, 
milk punch, etc., should be given, alternating so that 
some nourishment is administered as often as once in 
three hours. Stimulants, as already remarked, are to 
be given cautiously. 

During convalescence, tonics are necessary and may 
be given for a considerable length of time. 

SMALL POX 

Small pox or variola is an eruptive fever, propagated 
by a specific contagion, running a definite course, 
rarely attacking a person more than once, though cases 
are on record where it has attacked individuals twice 
and even three times. It is caused by exposure to a 






358 PAINLESS CHILDBIRTH 






small pox patient during the pustular period, or from 
excrementitious matter thrown off during the disease. 
How long this matter retains its infectious character 
is unknown, but it is certain that it may be conveyed 
in the clothing or otherwise a long time after these 
media have been exposed to the contagious material. 

Symptoms. — After exposure to the contagion, a 
period of incubation, varying from seven to eighteen or 
even twenty days — usually about twelve — elapses 
before any special indications of the disease appear. 
Then there is headache, lassitude, mental depression 
and a severe chill, or perhaps several chills in succes- 
sion. Fever develops with nausea and vomiting, in- 
tense pain in the back and legs, the headache becomes 
more severe, the mind confused, which may amount to 
delirium. The pulse is rapid, the tongue coated and 
the breath offensive, the throat sore and eyes bloodshot. 
In young children, convulsions are apt to occur before 
the eruption comes out. The fever continues high until 
the eruption appears, which will be from the end of 
the second to the fifth day. 

The eruption, which is the diagnostic mark of the 
disease, first appears on the forehead and scalp, about 
the eyes and mouth and then extends to the body and 
extremities. 

When the eruption is delayed till the fourth day and 
the pustules well separated from each other, the attack 
is likely to be mild and is called discrete small pox; 
but when it appears early and the eruption so close that 
the pustules run into each other, it is apt to be severe 
and is then termed confluent small pox. 

The eruption first appears as small red pimples, 
which gradually become more prominent. These 






DISEASES OF CHILDREN 359 

pimples are at first hard, but disappear for a moment 
under pressure. About the third day, and sometimes 
as early as the second, there appears upon the top of 
these pimples a small vesicle containing a transparent 
fluid, in the center of which there will soon appear a 
small depression or pit. They attain their size about 
the eighth day after the attack, and the fluid in them 
then becomes opaque and in two or three days they 
begin to dry down and form scabs. 

When the eruption has first appeared, there is a 
diminution of the fever, the headache and pain in the 
back and limbs are relieved, but return again about 
the seventh or eighth day and continue for a longer 
or shorter period, dependent largely upon the severity 
of the case and the amount of matter reabsorbed into 
the system; the chills and fever being due to the blood 
poisoning going on. 

About the tenth or eleventh day the swelling of the 
face subsides and the hands and feet swell. There is 
now great itching, and the vesicles break and pour 
out a liquid matter that forms crusts that are the cause 
of the disfiguring pits. 

In the severer forms the return of the fever is accom- 
panied with intense pain in the head and back, with 
delirium, which may be so acute as to necessitate con- 
stant watching. Diarrhoea and intestinal hemorrhage 
sometimes occur during this stage. 

In some cases the disease is so mild as to require 
little or no attention, while in others it is of the most 
malignant character, and the sufferer is reduced to a 
mass of putrescency. Between these extremes may be 
seen all grades of intensity. 



360 PAINLESS CHILDBIRTH 

Treatment. — Small pox has a regular course to run, 
and the object of treatment, therefore, is to mitigate its 
severity and guide it to a successful termination. 

It is highly important to isolate the patient at once 
and maintain a rigid quarantine to prevent the spread 
of the disease. Every person who has been exposed 
to the disease should be vaccinated at once. 

Secure a commodious, well ventilated apartment, 
where the atmosphere need not become loaded with 
the emanations from the patient, not too cold nor yet 
too hot, and maintain as nearly an even temperature 
as possible, and let the room be well disinfected by 
carbolic acid or other disinfectants freely sprinkled 
about. 

Give the patient a warm sponge bath two or three 
times a day, in which a small quantity of carbolic acid 
is dissolved. 

For two or three days before the characteristic 
eruption appears it will be difficult to determine the 
disease, unless it is prevailing in the vicinity or the 
patient is aware of having been exposed to it. As soon, 
however, as it is known that the disease is small pox, 
give: 

Fluid Extract Veratrum, . . 10 drops 

Fluid Hydrastis, ... 30 drops 

Water, ..... 4 ounces 

Mix, and to a child five years old give a teaspoonful every 
hour, lengthening the intervals as the fever subsides and increas- 
ing when the fever increases, and continue till the fever disappears. 
This will also control the stomach. 

The internal use of carbolic acid is believed by some 
to be of value in diminishing the severity of the blood 
poisoning, and a drop in half a wineglassful of water 
may be given three times a day. 



DISEASES OF CHILDREN 361 

The saracenia or pitcher plant has acquired some- 
thing of a reputation in this disease and is believed to 
materially lessen its severity. The infusion of the plant, 
an ounce steeped in a pint of water, and the whole taken 
in twenty-four hours, is regarded as the best mode of 
administration. 

Should the condition of the bowels require a laxa- 
tive, a seidlitz powder, calcined magnesia or some of the 
laxative mineral waters in appropriate doses may be 
given. 

Pain, irritation and wakefulness may be so severe 
at times as to demand the use of opiates, when pare- 
goric or tincture of opium or Dover's powder may be 
given in suitable doses to afford ease and sleep. 

To prevent pitting, a great variety of plans have 
been tried, but the principle of them all is to exclude 
the air. The following is a good formula: 

Carbolic Acid, .... 1 dram 
Fluid Hydrastis, ... 1 ounce 

Glycerine, .... 5 ounces 

Mix, and apply with a soft brush or camel's hair pencil, care- 
fully avoiding breaking the pustules. Repeat the application 
several times a day as often as it partially dries. It will allay 
the troublesome itching and disposition to scratch. 

Another method is to smear oil over the exposed 
skin and over it dust a powder composed of equal parts 
of bismuth subnitrate and prepared chalk. 

From the first, a supporting diet must be given — 
beef tea, mutton broth, eggs, milk, oysters, etc.; and 
particularly is nourishment demanded at the time of 
the maturation of the pustules; at this period the use 
of milk punch, brandy or whisky sling should be used 
to support the vital powers and favor the process of 
pustulation. If the eruption strikes in suddenly, warm 



362 PAINLESS CHILDBIRTH 

drinks should be given, and milk punch or camphor 
sling made by putting three or four drops of the spirits 
of camphor into a cup of warm sweetened water should 
be repeated every three or four hours. In the severer 
cases, the eyes should be protected by darkening the 
room or covering them with a mask. 

Diarrhoea may occur and should be treated with 
small doses of the neutralizing mixture and perhaps 
two to ten drops of the fluid extract of cranesbill, small 
doses of the tincture of cinchona, say five to ten drops 
for children every two or three hours, is well adapted 
to the necessity. 

During convalescence, nourishment is usually of 
more consequence than medicine, except the hydrastis 
in two or three-drop doses, or the cinchona in five or 
ten-drop doses, three times a day, increasing the dose 
in adult patients proportionately. 

VACCINATION 

Every baby should be vaccinated when it is five or 
six months old, because successful vaccination is 
almost certain protection against small pox. The 
vaccination should be repeated in the tenth year and 
after that every five to seven years. 

The outer side of the left arm is the place usually 
selected, but girls may, if preferred, be vaccinated on 
the thigh or leg. A shield should be worn as a protec- 
tion until the sore has thoroughly healed. 

CHICKEN POX 

Chicken pox or varicella is a mild, contagious erup- 
tive disease having some resemblance to small pox, but 
very much milder. An eruption appears — generally 
much scattered, principally on the body — as small red 
pimples, which in a few hours develop into vesicles, 



DISEASES OF CHILDREN 363 

and in rare instances become pustules. The rash first 
appears on the face and forehead and then spreads 
over other parts of the body. The pimples come in 
crops — new ones coming for three or four days. The 
rash may often be seen in the throat or mouth. In a day 
or two the vesicles dry up and scabs or crusts form 
that fall off in from five to twenty days ; neither scar 
mark nor pitting is left, except occasionally after a very 
severe attack. 

There is seldom any fever till the eruption appears, 
then the temperature raises somewhat and there may 
be headache, thirst, constipation, irritation of the eyes, 
severe itching, etc. 

School children should be quarantined for three 
weeks, or until all scabs have fallen off. 

But little or no treatment is necessary. If there is 
much fever, a mild laxative of citrate of magnesia and 
a few drops of aconite in a glass of water, given in 
teaspoonful doses every hour or two, is all that is neces- 
sary in the way of medicine. Itching of the skin can be 
allayed with carbolized vaseline. Infants should wear 
mittens to prevent scratching. A warm bath and pre- 
caution against taking cold should be employed. 

MEASLES 

Measles or rubeola is an acute contagious eruptive 
fever, due to a specific poison, propagated by contact 
with the sick or some article of clothing in which it 
may be carried long distances. 

Measles prevail epidemically at any and all seasons, 
but most generally during cold weather, and is then 
most severe, attacking all ages, but principally the 
young. It seldom attacks a person more than once and 



364 PAINLESS CHILDBIRTH 

is apt to be more severe among adults than children. 
It is attended with a more or less serious inflammation 
of the mucous membrane of the respiratory organs, 
varying from a slight catarrh to a severe bronchitis 
or pneumonia. 

Symptoms. — After a period of incubation varying 
from seven to fourteen days — generally about ten 
days — after the exposure, febrile symptoms accom- 
panied by catarrh make their appearance. The early 
symptoms may not differ materially from a common 
cold; there are chills and fever, coughing and sneezing, 
discharge from the nose; the eyes become inflamed, 
sensitive to the light and watery; there is headache, 
the throat feels raw and there is hoarseness with thirst, 
disturbance of the appetite, etc. These symptoms vary 
greatly in intensity. 

Usually on the fourth day from the beginning of 
these symptoms the characteristic eruption appears 
upon the face, in the edges of the hair and forehead, 
whence it extends to the neck, breast, body and ex- 
tremities, reaching its maximum in thirty-six to forty- 
eight hours. The eruption then remains stationary 
two or three days, when it gradually disappears in 
about the order of its appearance, and by the eighth or 
ninth day is all gone. 

This characteristic eruption appears as small dull 
or dingy red, slightly elevated circular spots resem- 
bling flea bites ; at first separate with intervals of natur- 
ally colored skin between them, but soon run together 
in such a manner as to form crescent-shaped patches, 
slightly elevated above the surface of the skin. 

Koplik's sign — a day or two before the rash appears, 
small, bluish white specks surrounded by a red areola 



DISEASES OF CHILDREN 365 

may be seen on the mucous membrane of the cheeks 
and lips. 

The symptoms described are sometimes varied and 
the eruption may appear out of its regular order. A 
person may wake in the morning after a restless night 
covered with the eruption without having noticed the 
early symptoms; or the " breaking out" may be de- 
layed beyond the fourth day. 

The only disease measles is likely to be confounded 
with is scarlet fever, but there are distinguishing 
features. The eruption of measles is darker than that 
of scarlet fever and gives the skin greater roughness; 
it being at first separate, then forming the crescent- 
shaped blotches, while the eruption of scarlet fever is 
usually in patches of a bright red color. 

In measles the eruption appears later then in scarlet 
fever. In measles it is first seen on the face and fore- 
head, in scarlet fever on the neck and chest. In measles 
the catarrhal symptoms are characteristic, except in 
very mild cases, but are rarely present in scarlet fever, 
though the throat is sore. These characteristics, though 
varying somewhat in different cases, will generally 
enable the reader to make a correct diagnosis. 

During the development of the eruption, the fever 
is generally pretty high, and there may be delirium, but 
when the measles are well out it subsides, unless the 
bronchial irritation is so severe as to cause its renewal. 
When the eruption declines naturally, yellowish dis- 
colorations remain and the skin is thrown off in fine 
scales. 

Sometimes the eruption is slow in coming out, or 
suddenly recedes after it has made its appearance, when 
the fever is likely to be greatly aggravated and the 



366 PAINLESS CHILDBIRTH 

bronchial irritation becomes a serious and troublesome 
complication. This often develops into pneumonia, 
which is liable to leave behind a pulmonary disease 
that may terminate in consumption. Ordinarily, 
measles are not a severe disease. Some years they are 
extremely mild, while in others the mortality is great. 

When the eruption is very dark and the powers of 
life greatly depressed, malignancy being the type of 
the disease, it is often termed black measles. 

Treatment. — As in all contagious diseases, the child 
should be isolated. The room must be slightly darkened 
on account of the condition of the eyes and the intoler- 
ance to light. Carbolized vaseline or washed lard will 
do much to allay the irritation or itching of the skin, 
and after the rash has disappeared warm baths should 
be given once or twice a day to assist the fine peeling 
of the skin. The eyes should be bathed night and morn- 
ing with a weak solution (10 grains to the ounce) of 
boracic acid and the throat sprayed three times daily 
with one part listerine and six parts water. In mild 
cases very little medicine is required, a hot foot bath, 
a warm sponge bath and warm drinks, with extra 
precautions against taking cold from exposure to 
draughts may be all that will be needed. Care must 
be taken to prevent taking cold for some time after 
the disappearance of the eruption. If the fever is exces- 
sive, aconite is the remedy and may be given alone or 
in connection with the pleurisy root or asclepias, thus : 

Tincture Aconite Root, . . 10 drops 

Fluid Extract Asclepias, . . 2 drams 

Water, ..... 4 ounces 
Dose — A teaspoonful every hour or two. This will not only 

modify the fever and induce moderate perspiration, but will 

materially aid in bringing out the eruption. 



DISEASES OF CHILDREN 367 

When the eruption is tardy in making its appear- 
ance I would add five drops of tincture of belladonna 
to the above prescription and give in the same way. 

Should the cough require a remedy, give: 

Tincture Ipecac, . . .15 drops 

Tincture Drosera, ... 30 drops 
Water, ..... 4 ounces 
Mix and give a teaspoonful every two hours, continuing the 
aconite. 

Compound licorice mixture in doses of five to thirty 
drops (according to age) will relieve the cough. 

The bowels should be opened with a soapsuds injec- 
tion or a dose of castor oil or calcined magnesia. 

Secure rest at night by a warm bath and, if necessary, 
a dose of Dover's powder adapted to the patient's age. 

When the irritation of the lungs is great and does 
not yield to the foregoing, as will sometimes be the 
case, and a true bronchitis or pneumonia developing, 
the chest should be enveloped in warm fomentations 
or poultices or the oiled silk jacket. Then give: 

Fluid Extract Lobelia, . . 3^2 dram 

Fluid Extract Asclepias, . 2 drams 

Morphine, • • • • K grain 

Syrup of Squills, ... 4 ounces 

Dose — One fourth to one teaspoonful every two to four hours, 
sufficient to afford relief, the dose to be varied according to age. 

Throughout the disease the diet should be nutri- 
tious. Give broths, soups, milk, milk punch, tea, toast, 
cereals, soft-boiled eggs, crackers, zweiback, jelly will 
make a good diet. Orangeade and lemonade may be 
given in moderate quantities. 

If the child complains of earache, notify the physician 
at once. 



368 PAINLESS CHILDBIRTH 

When all the symptoms are disappearing and the 
condition of the lungs does not require any special 
remedies I give tincture of Pulsatilla, ten drops in half 
a glass of water in teaspoonful doses every two or three 
hours. 

When there is great malignancy, supporting treat- 
ment is demanded, and milk punch, whisky toddy, 
beef tea, eggnog, etc., are called for. 

GERMAN MEASLES 

This is an acute contagious disease also known as 
Rubella, or Rotheln, that frequently occurs as an epi- 
demic. The constitutional symptoms are mild; the 
rash or eruption usually well marked, sometimes re- 
sembling that of ordinary measles, at other times that 
of scarlet fever. It may attack the same child a number 
of times as well as those who have previously had 
measles or scarlet fever. 

Symptoms. — For half a day the child may feel drowsy, 
be slightly feverish and complain of a little sore throat 
and watery eyes, but frequently the first symptom 
noticed is that the child when it awakes in the morning 
is covered with & rash. The eruption appears first on 
the face on the temple and cheeks and then spreads 
rapidly over the rest of the body. It consists of small 
reddish pimples, usually scattered, but on the face often 
forming blotches like that of measles. In other cases 
the eruption takes the form of a uniform reddish blush 
that closely resembles that of scarlet fever. The erup- 
tion lasts for two or three days, fades and disappears, 
sometimes with slight peeling or desquamation. The 
glands of the neck are usually enlarged and there may 
be some itching of the skin. 



DISEASES OF CHILDREN 369 

Treatment. — The disease is so mild that hardly any 
treatment is needed. The disease is contagious and the 
child should be kept away from other children for two 
weeks. Keep the bowels regular, sponge the body with 
tepid water two or three times a day. When the 
itching is severe, apply cacao butter or a bland oil to 
the skin. 

SCARLET FEVER 

Scarlet fever, scarlatina, or " canker rash," as it is 
variously called, is essentially a disease of childhood 
and rarely attacks a person but once. It is an acute 
infectious and contagious eruptive fever, characterized 
by a scarlet-colored eruption on the skin, associated 
with an inflammation of the throat. It is contagious 
from the outset of the disease to the end of desquama- 
tion or peeling and is communicated by contact or in- 
haling the exhalations of a person affected with it and 
may be conveyed in the clothing for long distances. 

Physicians recognize three varieties of the disease, 
distinguished by its severity: the simple, the anginose 
and the malignant. Scarlet fever in any form is to be 
dreaded, for it is a treacherous malady; an attack 
slight at first may become severe as it progresses and 
terminate fatally, and mild cases are often followed 
after convalescence is established by a fatal disease of 
the kidneys; on the other hand, cases that are severe 
at the outset become milder as they progress and ter- 
minate in complete recovery. 

Symptoms. — After exposure to the contagion, four to 
eleven days intervene, when the attack begins suddenly 
with chills, more or less severe, languor, headache, 
high fever, rapid pulse, nausea and vomiting. Convul- 
sions frequently replace the chills in young children. 



370 PAINLESS CHILDBIRTH 

The throat is sore, the tonsils swollen and inflamed. 
In twenty-four to forty-eight hours from the beginning, 
the characteristic eruption of the disease makes its 
appearance upon the neck and upper part of the chest, 
whence it extends over the rest of the body. There is 
rarely any rash around the mouth and chin and the 
pallor is in marked contrast to the rest of the face. 
In severe cases the eruption is delayed. 

The eruption consists of numerous little points or 
spots of a bright scarlet color which diffuse themselves 
uniformly over the skin or appear in large, irregular 
patches. This vivid color of the skin disappears under 
pressure, but quickly returns when the pressure is 
removed. 

At first the tongue is covered by a light yellowish 
coating through which numerous elevated points may 
be seen; about the fourth day this coating falls off, 
leaving the surface of the tongue raw and the elevated 
points swollen, giving it something the appearance of 
a large strawberry, from which we have "the straw- 
berry tongue" of scarlet fever. 

About the fifth day from the beginning of the attack 
the eruption begins to fade, and in a day or two — 
remaining longer in severe than in mild cases — it has 
entirely disappeared. The eruption is often attended 
by a troublesome itching; as it recedes, desquamation 
or peeling of the skin commences, first falling off in a 
minute scurf and later in large scales. This peeling 
lasts for two or three weeks, or even longer. 

In the mild or simple variety the symptoms are mild, 
and the trouble of the throat is not severe, the erup- 
tion comes out early and is of a pale rose color and 
soon fades. 



DISEASES OF CHILDREN 371 

In the anginose form, all the symptoms are aggra- 
vated, the swelling of the throat is severe and swallow- 
ing very difficult. On examination of the throat, the 
tonsils are seen swollen, dark red and the mucous mem- 
brane presents more or less ulceration; the breath is 
offensive and there is an acrid discharge from the nose, 
and the glands of the neck are inflamed, often forming 
abscesses. The eruption is more general, and the whole 
body presents the appearance of a " boiled lobster." 

The occurrence of the eruption gives no relief, but 
all the symptoms are apt to be aggravated. In this 
form the eruption does not follow the regular course, 
it does not come out so early and may soon recede; 
it often shows a tendency to recede and reappear, and 
the throat is likely to remain sore for some time. 

In the malignant form w r e have all the severity of 
the anginose variety from the first, and a state of pros- 
tration soon develops that rapidly assumes all the 
characteristics of typhoid. The pulse is small, irregu- 
lar, indistinct, soft and so rapid as scarcely to be 
counted. The eyes are a dull red, with intolerance of 
the light, the cheeks flushed and dusky and there is 
deafness and delirium or stupor. The eruption is very 
dark colored, comes out late and disappears again in 
a few hours. 

The tongue, teeth and lips are covered with dark 
incrustations, the breath is exceedingly fetid, the 
breathing is rattling and laborious; swallowing exceed- 
ingly painful and difficult, sometimes the whole neck 
becomes a dark livid color, the throat sloughs and an 
offensive diarrhoea occurs. These symptoms are very 
likely to terminate in death on the second, third or 



372 PAINLESS CHILDBIRTH 

fourth day. This form of the disease, even under its 
most favorable circumstances, is extremely fatal. 

Severe kidney complications may occur in any form 
of the disease, and attention to the secretion of the urine 
should never be overlooked, as entire suppression 
sometimes takes place. Other possible complications 
are swelling and suppuration of the glands of the neck, 
purulent inflammation of the middle ear, inflamed 
joints. 

Treatment. — In the milder forms of the disease the 
objects of treatment are to modify the fever and pro- 
mote the appearance of the eruption. The patient should 
be isolated in a large easily ventilated room, as far 
away as possible from the rest of the family; all unnec- 
essary furniture and draperies should be removed; 
the air should be pure and the temperature about 
68° F. A sheet wet with some disinfectant should be 
hung over the door and nothing must be allowed to 
leave the room unless it has been thoroughly boiled 
or disinfected. A tepid sponge bath repeated two or 
three times a day will materially aid in promoting the 
comfort of the patient by reducing the fever, and by 
assisting the peeling and preventing the scales from 
the skin from flying about will act as a preventive 
against spreading the disease. This bath may be ren- 
dered more efficacious by making it alkaline by adding 
a tablespoonful of saleratus or baking soda to each 
quart of water. Then give internally: 



Tincture of Aconite Root, . . 10 drops 

Tincture of Belladonna, . . 5 drops 

Water, ..... 4 ounces 
Dose — A teaspoonful every hour or two as the fever is severe 
or mild. 



I 
1 



DISEASES OF CHILDREN 373 

Warm drinks, mint teas, warm lemonade or hot 
whisky sling in moderation are useful in bringing out 
the eruption. 

In the anginose form, make use of the bath and warm 
drinks and give internally: 

Fluid Extract of Veratrum, . 10 drops 

Fluid Extract of Baptisia, . . 30 drops 

Water, ..... 4 ounces 
Dose — A teaspoonful every hour. 

Give two-grain doses of the second trituration of 
the red iodide of mercury every three or four hours 
and between the doses gargle the throat with the 
chlorate potash solution or, in its stead, gargle with the 
following : 

Powdered Cayenne Pepper, . 1 teaspoonful 

Salt, ..... 2 tablespoonfuls 

Cider Vinegar, .... 4 ounces 

Boiling Water . to make 1 pint 

Infuse and strain and use freely. 

The pungency of this mixture will make it objection- 
able to small children, but its use is apt to be followed 
by speedy relief. Children too small to use a gargle 
may have the throat mopped out with a soft brush 
or sponge, but rough usage is not to be permitted. 

As a spray to the throat use the peroxide of hydro- 
gen formula mentioned in the treatment of sore throat, 
page 345. 

If the bowels require unloading, an injection of soap 
and water or a dose of castor oil should be given. 



374 PAINLESS CHILDBIRTH 

A stimulating liniment applied to the neck on a 
layer of flannel is serviceable and the following answers 
well: 

Hemlock Oil, . . . . % ounce 

Olive Oil, . . . }/2 ounce 

Spirits of Hartshorn, . . 3^ ounce 

Spirits of Camphor, }/$ ounce 
Mix. 

Anointing the entire body three or four times a day 
with vaseline or cacao butter does much good, allaying 
the troublesome itching and promoting the comfort of 
the patient. A ham or bacon rind is equally good if 
not better, though not quite so nice or fashionable. 

If there be great prostration, stimulants may be 
required, when milk punch, eggnog, wine whey, etc., 
are the most desirable forms. If they quiet and strength- 
en, they do good, but if they cause delirium they do 
harm and should be suspended. 

If there is great nervousness, give a few doses of: 

Tincture of Gelsemium, . . 60 drops 

Water, ..... 4 ounces 
Dose — A teaspoonful every two or three hours, timing its 

administration so as not to interfere with other remedies that are 

being given at stated intervals. 

If the functions of the kidneys fail and the urine 
becomes scanty and thickens on being heated, give: 

Acetate of Potash, . . . 2 drams 

Tincture of Apis, . . .15 drops 

Water, . . . . .4 ounces 

Dose — A teaspoonful every four hours in plenty of water. 

Care must be taken to determine that instead of 
there being no urine secreted, the bladder be not over- 
full, having lost its power of evacuation. When this 
is the case, the bladder can generally be felt distending 



DISEASES OF CHILDREN 375 

the lower abdomen. A hot sitz bath may afford relief 
or a hot fomentation of hops on which a little spirits 
of camphor is sprinkled may be applied over the bladder. 
If these fail, instrumental measures will be necessary. 
The bedding of children too young to tell may be found 
wet and yet the bladder be distended with urine, that 
which dribbles away being in excess of the capacity 
of the bladder. Distinction must be made between 
suppression, or failure of the . kidneys, and retention, or 
failure of the bladder to expel its contents. 

In the malignant form of the disease, treatment is 
very uncertain and unsatisfactory, yet every effort 
must be made. Stimulants are to be given persever- 
ingly, brandy, milk, beef tea, eggs, etc., and this medi- 
cine internally : 

Tincture Rhus Tox, ... 5 drops 

Tincture Belladonna, . . 8 drops 

Fluid Extract Baptisia, . . 1 dram 

Water, ..... 4 ounces 

Mix. Dose — A teaspoonful every two hours. 

Throughout the disease a nutritious diet should be 
given and alternated so that every few hours some 
easily digested nourishment is given, as beef tea, mutton 
broth, eggs, milk punch, junket, wine, soft toast, etc., 
etc. 

Disinfectants should be exposed in the room, as 
chloride of lime, sulphurous acid gas, carbonic acid gas, 
carbolic acid, etc., as has been advised in diphtheria, 
small pox, etc. 

Dropsical complications may occur after the sub- 
sidence of the other symptoms, usually about the 
twenty-first day, and seems most liable to follow those 
cases that have been mild. When it occurs, put ten 



376 PAINLESS CHILDBIRTH 

drops of apis and thirty drops of apocynum canabinum 
in a goblet half full of water and give a teaspoonful 
every four hours and alternate with ten drops of 
Fowler's solution in a like quantity of water, given in 
teaspoonful doses between the doses of the other. 

The alcoholic vapor bath may also be used at the 
same time with a view to remove the dropsical effusion 
through the skin by perspiration. 

During convalescence in the severer cases, tonics 
are needed, and the elixir of calisaya and iron in appro- 
priate doses suits the requirements well. 

It is perhaps needless to add that a physician be 
called at the outset who can watch the developments 
of the case and take advantage of conditions as they 
arise. I have detailed the treatment more particularly 
for the benefit of those who cannot have medical aid 
without delay, and as a guide in his absence and not 
by any means to supersede him. 

ERYSIPELAS 

This affection is a peculiar form of inflammation 
of the skin and tissues immediately beneath it, with a 
disposition to extend itself over large surfaces and 
accompanied by more or less severe febrile disturbance. 
It sometimes occurs as an epidemic, though isolated 
cases of the simple form are often met. It is an acute 
contagious disease due to a germ — the Erysipelas 
Streptococcus — that enters the body through a wound 
or abrasion of the skin. Facial erysipelas usually starts 
from a small wound at the edge of the eye, nose or 
mouth. In new-born babies it may start from the navel. 

Symptoms. — In the simplest or superficial variety 
there may not be very general disturbance, the disease 
being localized on the skin. The skin inflames and is 



DISEASES OF CHILDREN 377 

attended by an intense itching or burning sensation, 
with redness, which so gradually merges into the sur- 
rounding tissues that it is almost or quite impossible 
to tell where it begins or ends. This simple form scarcely 
merits a description except to illustrate an extreme of 
the disease. 

In the severer forms, in addition to the symptoms 
mentioned, there is a chill at the outset, though it may 
be slight, soon followed with fever, loss of appetite, 
headache, nausea and perhaps vomiting, and there 
may be stupor or delirium when it attacks the face 
or head. A sensation of intense heat is felt in the skin 
where the disease shows itself, stinging and itching and 
attended with a swelling or puffiness, with a vivid red- 
ness which in a little while assumes a purple hue. The 
swollen skin presents a glistening appearance and is 
very sensitive. 

Erysipelas frequently attacks the face and head, 
though no part of the body is exempt. When it occurs 
in loose tissues like the eyelids the swelling is much 
greater than in tightly drawn tissues, but the latter 
are most painful. The swelling of the face is often 
extreme; the eyes may be closed and great deformity 
exist. Sometimes small blisters or vesicles appear on 
the affected surface. When the deeper structures are 
affected, abscesses form and typhoid symptoms are 
developed. The inflammation generally reaches its 
height in two or three days, and in a day or two longer 
gradually declines and the skin assumes a yellowish 
hue and peels off. 

It often happens that when the inflammation has 
arrived at its greatest height at the point of its com- 
mencement it will spread to adjacent tissues before 



378 PAINLESS CHILDBIRTH 

it declines and in other instances advances in one 
direction as it declines in another, while at other times 
it leaves one point to attack another entirely remote. 
This form is known as migratory erysipelas. When 
situated on the head and face there is always danger 
of inflammation of the brain. 

Its ordinary duration is from seven to fourteen days, 
but it may assume an erratic form and wander about, 
receding in one direction and spreading in another, 
keeping up its maximum severity. 

Treatment. — Wash the inflamed part with Castile 
soap and water, then bathe with a 1 in 1000 solution of 
corrosive sublimate; dry with soft towel and apply 
white lead or the following salve: 

Ichthyol, . . . . . 2 drams 

Vaseline, .... 1 ounce 

Directions — Spread on inflamed part, cover with gauze, cotton 
or linen and hold with bandage. 

It is well to give children five drops of the tincture 
of chloride of iron in a wineglass of water three or 
four times a day, however mild the case may be. 

The use of iron as already described, alone or asso- 
ciated with quinine, is a very popular remedy with 
many physicians, particularly when the disease attacks 
persons previously debilitated. 

When constipation is present, a laxative may be 
necessary, and a seidlitz powder, Rochelle salts, cal- 
cined magnesia, or even castor oil may be given. The 
diet must be nutritious and sustaining — animal broths, 
toast, tea, milk, etc., and, if the prostration is great, 
stimulants may be necessary. Cool or tepid sponging 
of the body will always allay fever and add to the 
patient's comfort. Let the hygiene be as thorough as 



DISEASES OF CHILDREN 379 

possible. During recovery, iron and calisaya makes an 
agreeable tonic. 

NOSE BLEED— EPISTAXIS 

Blows on the nose, picking at the nose, plethora, 
growths and ulcers, catarrh, are the most frequent 
causes of bleeding from the nose. 

Treatment. — Pinching the nose between the fingers 
will sometimes stop the bleeding. Powdered alum, 
pure or mixed with an equal quantity of starch, blown 
into the nose, or a small piece of absorbent cotton or 
bacon fat inserted just inside the nostril will often 
check the hemorrhage. Peroxide of hydrogen, lemon 
juice or weak vinegar may be sprayed into the nose 
with an atomizer. Raising one or both hands above 
the head, a small piece of ice to the outside of the nose, 
a hard substance, like a marble or thimble, placed be- 
tween the front teeth and upper lip are simple means 
that have often proved successful. 

Solutions of adrenalin and antipyrin are excellent 
remedies often used by physicians. 

DIARRHCEA 

Diarrhoea is an affection characterized by an in- 
creased frequency of the discharges from the bowels, 
of variable quantity and consistence, associated with 
derangement of the digestive function. It prevails 
largely among children at all seasons, but principally 
in the summer months. It often occurs as a symptom 
of other diseases and is one of the consequences of 
general blood poisoning. It is due largely to irritation 
of the intestinal tract from overloading the stomach, 
eating unripe, indigestible or irritating food, the pres- 
ence of w r orms, imperfect digestion, biliary disturb- 
ances, want of tone in the bowels, teething, etc.; and 



380 PAINLESS CHILDBIRTH 

in young children it is often caused by improper arti- 
cles of food when the child first commences to eat, 
impure milk, etc. 

Symptoms. — The symptoms of diarrhoea vary con- 
siderably. There are frequent evacuations of the bowels 
of a more fluid character than is natural. The dis- 
charges are generally preceded by a rumbling noise, 
uneasiness in the lower part of the abdomen, with a 
sense of weight or pressing down, which is relieved as 
soon as the evacuation is completed, but returns before 
the succeeding one occurs. In some cases the griping 
is severe, while in others it may be wholly absent. The 
tongue is usually coated, there is a bad taste in the 
mouth and often nausea and vomiting. If the disease 
continues long, the strength is reduced, emaciation 
occurs, all the various functions are disturbed and the 
skin becomes dry and sallow. The appearance of the 
stools varies greatly. 

In diarrhoea arising from irritation of the bowels, 
due to acrid, indigestible food, green vegetables, over- 
feeding, the presence of worms or from cold, etc., there 
are frequent copious, offensive discharges, preceded by 
griping, flatulence, nausea with coated tongue, loss of 
appetite, headache and, if it continues any length of 
time, prostration. When indigestible food is the cause, 
particles of the food may be seen in the evacuation. 
If due to worms, these parasites whole or in pieces may 
be seen, but the reader is referred to that subject for 
a more complete description. When from teething, 
there will in addition to the other symptoms be irri- 
tation of the nervous system, swelling of the gums and 
the symptoms generally accompanying teething. 



DISEASES OF CHILDREN 



381 



Figure 37 



targe 
fntesttne\ 




ijj l or ye 
Intestine 



Vermiform / i 

Appendix ' 

/ 

/ 

Small /ntesttne \ \ Rectus 



The Stomach and Intestines 



382 PAINLESS CHILDBIRTH 

When the disease is due to lack of tone in the intes- 
tines, the relaxed vessels pour the watery portion of 
the blood into the intestinal canal where it is mixed 
with the other matters, thus causing copious watery 
stools in addition to the other symptoms. The pros- 
tration in this form is rapid. When diarrhoea is caused 
by an excessive secretion of bile, the passages will at 
first be mixed with greenish yellow matter, semi-solid 
and offensive, which as the disease advances becomes 
more watery. The mixture of the vitiated bile with 
the acids of the stomach when present in much quan- 
tity in the intestines occasions severe griping and offen- 
sive green discharges mixed with mucus. The griping 
does not wholly cease after the evacuation, and there 
is tenderness in the right side and pit of the stomach. 
The mouth tastes bitter, the tongue has a dirty yellowish 
white coat, the appetite is lost, the skin is dry and the 
urine scanty and highly colored. The presence of bile 
in the stools can generally be recognized by its appear- 
ance and smell. These symptoms may be so combined 
and varied that a given case will not admit of classifi- 
cation under any of the recognized forms of the dis- 
ease, and the discharges may amount to merely a 
looseness and may consist of mucus or be watery and 
present every shade of color and odor. 

Treatment. — When the diarrhoea is due to the 
presence of irritating materials in the intestinal canal, 
as unripe fruit, indigestible food, etc., or the excessive 
secretion of bile, it is a good plan to preface all treat- 
ment with a mild purgative, which aids the efforts 
of nature by the expulsion of the offending matter and 
often puts an end to the whole trouble. For this 



DISEASES OF CHILDREN 



383 



purpose a good dose of castor oil should be given or, if 
preferred, the following prescription that very nearly 
resembles the old fashioned neutralizing mixture. Take: 



Fluid Extract of Rhubarb, 


2 drams 


Bicarbonate of Soda, 


2 drams 


Essence of Peppermint, 


Y2 dram 


Brandy, .... 


4 drams 


Simple Syrup, . 


4 drams 


Water, sufficient to make 


4 ounces 



The dose of this for children from two to five years old is a 
teaspoonful or a little less repeated every two hours, until it 
appears in the stools, or a bright yellow color is seen in them, 
when it is to be stopped. 

If either of the foregoing does not put a stop to the 
diarrhoea, make use of the following mixture: 



1 dram 

1 dram 

1 dram 

l A dram 



Tincture of Camphor, 

Tincture of Opium, . 

Tincture of Catechu, 

Tincture of Capsicum, 

Essence of Peppermint, . . 3^2 dram 

Elixir of Lactopeptin, to make . 2 ounces 

Dose — Ten to thirty drops, according to the age of the child, 
repeated every two to four hours, or oftener in violent cases. It 
should be given in warm sweetened water. 

Apply hot fomentations or a hot water bag to the 
abdomen. 

With these two prescriptions the majority of diar- 
rhoeas may be controlled, varying the doses to suit 
the age of the patient and violence of the attacks. 

Diarrhoea in which the tongue is heavily coated, but 
which is not due to overeating, etc., but in which there 
is griping, flatulence, rumbling noise in the bowels, 



384 PAINLESS CHILDBIRTH 

with offensive semi-fluid stools, is generally controlled 
very readily by : 

Fluid Extract of Mandrake, . 5 drops 

Fluid Extract of Veratrum, . 3 drops 

Water, ..... 4 ounces 
Dose — A teaspoonful every hour or two. 

Painless watery diarrhoea will usually yield to five 
drops of the compound tincture of cinchona in a tea- 
spoonful of water, repeated every hour or two. It is 
also beneficial in those cases in which there is a want 
of tone in the intestines. 

Great care should be excercised in administering 
opiates and astringents to children in intestinal dis- 
orders for, though potent for good when properly em- 
ployed, they are equally productive of harm when 
mismanaged. 

During the disease, attention must be paid to the 
diet, and only light and easily digested food should be 
allowed. Toast, rice, boiled milk are among the best 
articles. The patient should at the same time be kept 
in bed. 

DYSENTERY 

This disease, also known as flux, bloody flux, colitis, 
etc., is an acute inflammatory affection of the lower 
bowel, attended with looseness. It is usually confined 
to the lower portion of the large intestine and is at- 
tended with severe straining, bearing down, fever and 
bloody stools — symptoms that distinguish it from 
diarrhoea. 

Dysentery frequently occurs as an epidemic and is 
then more severe and fatal than when it occurs in iso- 
lated cases. It is met with oftenest during the autum- 
nal months. When dysentery occurs as an epidemic, 






DISEASES OF CHILDREN 385 

it is supposed to be due to some poisonous germs 
floating in the atmosphere. It is also caused by malaria 
and, when occurring in the fall, may be due to cold 
and moisture following intense heat, cold, improper 
diet, etc.; a cause of considerable importance is the 
chilling of the surface of the body during the autumn, 
when cool nights follow hot days. A person retires 
with a covering sufficiently comfortable at the time, 
but wakes in the night with a sense of chilliness. This 
causes the blood to recede from the surface and, being 
driven upon the intestines by repetition, predisposes 
to the development of dysentery on the operation of 
some additional cause, however slight. 

Symptoms. — It will frequently be observed that con- 
stipation has preceded the attack, but for a couple of 
days before the disease develops there is loss of appe- 
tite, languor, uneasiness or tenderness in the lower part 
of the abdomen, chilliness, nausea, etc.; soon there is an 
increased frequency of the evacuations, with griping, 
etc.; as inflammation develops in the lower bowel 
there is burning and pain in the rectum, the discharges 
become more frequent and less abundant; there is a 
constant desire to go to stool, and great efforts are 
made to expel something, which only results in the 
ejection of small quantities of mucus which are apt to 
be streaked with blood. As the discharges pass through 
the inflamed parts they occasion intense pain. 

These symptoms continue to increase and the quan- 
tity of blood becomes greater. The evacuations vary 
in appearance, sometimes frothy, containing portions 
of fecal matter, mucus and blood. Again they appear 
like the washings of meat; sometimes they are wholly 
mucus or perhaps pure blood. More or less fever 



386 PAINLESS CHILDBIRTH 

attends these symptoms, with dry, coated tongue, 
thirst, great prostration and in malarious sections there 
will be evidence of congestion of the liver and obstructed 
circulation. 

Dysentery has no regular duration and may yield 
in a few days or it may be protracted into weeks. As 
the disease progresses, ulceration of the parts affected 
is liable to occur when pus will appear in the discharges. 
The appearance of brown, chocolate-colored discharges, 
great prostration, typhoid symptoms, etc., indicate 
great danger; but the reappearance of the fecal matter, 
except when it is passed in hard lumps, is generally a 
favorable omen, as a decline in the inflammation is 
likely to follow, even though the suffering and all the 
other symptoms may continue for two or three days 
longer before much improvement is noticed. 

Treatment. — To empty the bowels by the use of 
the rhubarb mixture advised for diarrhoea before the 
development of severe inflammatory symptoms is a 
judicious measure. Then put the patient upon: 

Tincture of Aconite Root, . . 10 drops 

Fluid Extract of Gelsemium, . 10 drops 
Water, ..... 4 ounces 

Dose — A teaspoonful repeated every two hours, unless the 
characteristics of gelsemium appear, as double or indistinct 
vision, drooping lids, etc., when the dose must be lessened or 
given at longer intervals. This will not be likely to occur from 
this dose, except in very young children. For adults the dose 
must be materially increased. Alternate the foregoing with: 

Corrosive Sublimate, . . K grain 

Fluid Extract of Ipecac, . 1 dram 

Water, ..... 8 ounces 

Dose — A teaspoonful every two to four hours, according to 
the severity of the symptoms. 



DISEASES OF CHILDREN 387 

These remedies have proved themselves so near 
specifics in my hands that I place great reliance upon 
them. 

If the pain and tenesmus are severe, a few doses of 
paregoric or laudanum may be prescribed by the 
physician until some degree of comfort is obtained. 

Washing out the bowel slowly and gently with mild 
antiseptic solutions will often prove beneficial. 

Diet is of the greatest importance in this disease, 
and no solid food is to be permitted. During the acute 
attack give pasteurized or peptonized milk, or lime 
water and milk in about the proportion of one part of 
the former to eight of the latter. As patient improves, 
give arrowroot, custard and other easily digested foods. 
To allay the thirst permit small pieces of ice to slowly 
dissolve in the mouth; this is far better than copious 
draughts of any liquid. 

The whole body should be frequently sponged with 
warm water made alkaline with a little soda. Warm 
fomentations of hops or hot water bag over the abdo- 
men will often afford material relief. They must be 
light and never be wet enough to drip. The sick cham- 
ber should be kept well ventilated and disinfected with 
carbolic acid, daily, and the discharges from the bowels 
must be removed at once and thoroughly disinfected. 

ACUTE INTESTINAL CATARRH 

This disease, also called muco enteritis, is an inflam- 
mation of the mucous membrane of the small intestine. 
It may result from cold or the irritation of particles 
of undigested food, or from other causes of intestinal 
troubles. It may extend upward and involve the stom- 
ach or downward to the large intestine. 



388 PAINLESS CHILDBIRTH 

Symptoms. — Muco-enteritis generally begins with 
pain and tenderness about the navel, griping and a 
frequent desire to evacuate the bowels. There is diar- 
rhoea, but whether the evacuations be large or small 
they do not relieve the desire to go to stool. The evacu- 
ations vary, sometimes yellowish, thin, acrid and mixed 
with mucus and sometimes tinged with blood. If the 
stomach is involved there will be vomiting. If it ex- 
tends to the large intestine there will be the straining 
characteristic of dysentery. There is languor and chilli- 
ness or perhaps a severe chill, fever and pain about 
the navel, the appetite is lost, the tongue coated with 
a yellowish fur and, in the severer cases, it is dry with 
redness of the tip and edges. In some cases the pros- 
tration is great and typhoid symptoms develop, pres- 
sure on the bowels reveals tenderness and pain, the 
stools are variable, the desire irresistible, yet perhaps 
very little or nothing passes. 

Treatment. — The use of the popular " diarrhoea 
medicines " in these cases is often worse than nothing, 
frequently aggravating the disease. The function of 
the skin should be re-established as soon as possible, 
and for this purpose a vapor bath or even a warm bath 
should be employed at the commencement. The 
patient should then be put into a warm bed and moder- 
ate perspiration promoted, care being taken when 
getting up to evacuate the bowels to be well wrapped 
to prevent taking cold. I then give: 

Tincture of Aconite Root, . . 10 drops 

Fluid Extract of Ipecac, . . 10 drops 

Water, ..... 4 ounces 

Dose — A teaspoonful every hour or two. Alternate this with: 






DISEASES OF CHILDREN 389 

Fluid Extract of Mandrake, . 10 drops 
Water, ..... 4 ounces 
Dose — A teaspoonful every two to four hours between the 

other doses, and continue it until the discharge becomes more 

natural in appearance and consistence. 

If there is much blood in the stools with mucus and 
severe straining, in place of the mandrake I would give : 

Corrosive Sublimate, . . 3^2 grain 

Water, ..... 8 ounces 
Dose — A teaspoonful every four hours. 

Counter-irritation over the bowels with mustard or 
with turpentine applied a few moments at a time on 
a cloth answers a good purpose in many cases. 

The thirst, which is sometimes extreme, may be 
allayed by allowing small pieces of ice to melt in the 
mouth and will not aggravate the diarrhoea as large 
quantities of fluids are apt to do. The diet must be 
light and no solid food allowed. Pasteurized or pep- 
tonized milk or milk and lime water should be given 
in small quantities at regular intervals. The warm 
sponge bath should be repeated two or three times a 
day, As a rule, opiates do not act kindly in these 
cases. 

Usually this treatment will produce a very favorable 
impression in two or three days, but care must be ob- 
served, for the disease is extremely liable to relapse, 
even after the discharges have had a natural appear- 
ance for several days. When a relapse occurs, it neces- 
sitates a repetition of the treatment, in which case 
it is to be supplemented with a few doses of qui- 
nine, proportioned to age, given after the active symp- 
toms have declined. This is more particularly demanded 
when malarial influences exist. A looseness of the bowels 



390 PAINLESS CHILDBIRTH 

sometimes remains that will demand the administra- 
tion of astringents. For this purpose two to five-drop 
doses of fluid extract of cranesbill is one of our best 
remedies and may be repeated two to four times a 
day. A pure article of Hungarian wine answers an 
excellent purpose,, combining as it does an excellent 
astringent with a mild stimulant; it must, however, be 
used cautiously or it will induce constipation that may 
be followed by a relapse. An infusion of red raspberry 
leaves answers well. Blackberry cordial or an infusion 
of the blackberry root are agreeable astringents and 
some of them are always within reach. 

CHOLERA MORBUS 

This is an acute disease, characterized by vomiting 
and purging, associated with derangement of the func- 
tions of the liver. It may occur at any period of the 
year, but is most frequently met with in the latter part 
of summer and autumn and prevails more extensively 
some years than others. The influence of extreme heat 
upon the functions of the liver is a powerful predis- 
posing cause. Sudden changes in the weather, eating 
improper food, unripe vegetables and fruits, of which 
cucumbers, green apples and plums are most deserv- 
ing of mention, drinking freely of icewater when over- 
heated, ice cream, impure milk, etc., etc., are the most 
frequent exciting causes. 

Symptoms. — In a large per cent of cases it will be 
ascertained on careful inquiry that there has been 
present for a few hours or days some derangement of 
the stomach, nausea, coated tongue, flatulence, with 
a sense of weight and oppression, as if some of the food 
eaten remained in the stomach undergoing fermenta- 
tion instead of being digested, sometimes accompanied 



DISEASES OF CHILDREN 391 

by diarrhoea. These premonitory symptoms are not 
always present or are so mild as to attract little or 
no attention. 

The real attack generally comes on suddenly and 
violently; sometimes a severe chill awakens the patient 
from a sound sleep, soon to be followed by a pain in 
the bowels, nausea, vomiting and purging. At first 
the matter vomited will consist of partly digested 
food mixed with mucus and a dirty yellowish or greenish 
fluid, and the discharge from the bowels will consist of 
ordinary feces mixed with a similar matter as that 
ejected from the stomach. The discharges become more 
fluid as the disease goes on, containing for a time more 
or less vitiated bile. In severe cases the discharges soon 
take on the characteristic "rice water " appearance of 
Asiatic cholera. The discharges are profuse, frequent 
and sudden and rapidly exhaust the patient, so that 
he becomes so weak as to scarcely be able to move in 
bed. The w r eight of the body is rapidly reduced. There 
is a terrible thirst present, but drinks are rejected almost 
as soon as swallowed. Spasmodic contractions of the 
muscles of the lower extremities frequently occur and 
sometimes the abdominal muscles are involved. These 
cramps are exceedingly painful. The pulse is- small and 
frequent, the surface cold and bathed with a cold 
perspiration, the face appears blue and pinched. If 
relief is not obtained the prostration is increased, the 
mind wanders, insensibility and collapse occur to end 
in death. The disease lasts from a few hours to two or 
three days, but sometimes it is followed by a secondary 
fever lasting a week or more. Usually the disease is 
easily recognized and in the majority of cases, particu- 
larly with proper management, recovery takes place. 



392 PAINLESS CHILDBIRTH 

Treatment. — The irritable condition of the stomach 
demands attention. The time was when emetics were 
regarded as about the only thing capable of accom- 
plishing this object, but alas! how mankind changes. 
Emetics are no longer the fashion and we seek to accom- 
plish the same end by entirely different means, and 
we suggest : 

Fluid Extract of Ipecac, . 5 drops 

Fluid Extract of Veratrum, . . 5 drops 

Water, ..... 4 ounces 

Dose — A teaspoonful every ten minutes. 

Apply over the stomach a mustard paste or plaster 
and keep it on until the skin is considerably reddened. 
Apply dry warmth to the extremities; brisk rubbing, 
with or without dry mustard, will aid in stimulating 
the circulation and relieving the cramps. Endeavor 
to restore warmth to the surface. Do not permit large 
draughts of any fluid, but allay the thirst by allowing 
small bits of ice to melt in the mouth. Give internally: 

Tincture of Camphor, 
Essence of Peppermint, 
Essence of Jamaica Ginger, 
Chloroform, 
Brandy, to make 

Dose — Five to fifteen drops according to the age of the child, 
with larger doses for adults, given in hot water sweetened and 
repeated every fifteen to thirty minutes, oftener if rejected. 
At the same time continue the ipecac and veratrum. 

This prescription alone is a powerful stimulant to 
the nervous system, aids in controlling the vomiting 
and diarrhoea, relieves the cramps in the extremities 
and fulfills most of the indications that call for medi- 
cine in the disease. 



1 dram 


Yz dram 


1 dram 


1 dram 


2 ounces 



DISEASES OF CHILDREN 393 

When the stomach has been brought under control, 
we may use the following for the liver: 

Tincture of Leptandra, . . 1 dram 

Aromatic Syrup Rhubarb, . 1 ounce 

Dose— A teaspoonful every two or three hours until bile is 

seen in the stools and they begin to appear natural again. This 

dose is for a child from five to ten years old. 

Friction and dry warmth to the extremities must 
not be overlooked, for this and cholera are the diseases 
above all others in which "heat is life." 

Sometimes the vomiting is very obstinate. If it 
does not yield to the measures already advised in a 
short time, other means should be employed. Iced 
champagne will sometimes succeed. An infusion of 
peach leaves is efficient in some cases or, if it can be 
procured, the compound tincture of cajeput in fifteen 
to twenty-drop doses every quarter or half hour is 
one of the best remedies. It is best taken on a little 
sugar. If collapse threatens, artificial warmth and 
stimulants and two drops each of the tincture of cam- 
phor and cayenne in water every ten or fifteen minutes. 
Inhalation of ammonia is also beneficial. If necessary, 
persevere with these means and many apparently hope- 
less cases will be restored to health. 

After the acute symptoms are over there will remain 
a debility and prostration which may be met with 
the following: 

Tincture of Cinchona Compound, 3^2 ounce 
Tincture of Nux Vomica, . . 20 drops 

Simple Elixir, to make . . 4 ounces 

Dose — One half to one teaspoonful three times a day, larger 
doses for grown persons. 

Convalescence is usually rapid. 



394 PAINLESS CHILDBIRTH 

SUMMER DIARRHCEA— CHOLERA INFANTUM 

This disease, popularly termed the " summer com- 
plaint of children/' is one of the greatest foes of in- 
fancy and is one of the most difficult diseases we are 
called upon to treat. It prevails more extensively in 
cities and towns than in the country and is usually 
met with in the first and second years of a child's 
existence. In large cities almost one half the deaths 
in infants under one year old are caused by summer 
diarrhoea. It is most frequent in bottle-fed babies. 
There are several varieties of the disease, a fact that 
has occasioned much diversity of opinion; and as any 
attempt to distinguish the different types of the disease 
could only result in confusing the readers, I will omit it. 

There is a serious perversion of the nutritive func- 
tions with vomiting and diarrhoea, sometimes acute, 
at others chronic, sometimes accompanied by fever and 
sometimes without. 

Causes. — Impure food, the heat of summer, bad 
water, bad air, unhygienic surroundings, irritation of 
the nervous system from teething, etc., all contribute 
to the production of the disease. Frequently several 
of these causes are combined. The country districts 
present decided advantages for children; there the heat 
is not usually so intense or continuous; the ventila- 
tion is better; the water pure and not poisoned by the 
conductors it traverses; the milk is better, unmixed 
and unadulterated and not subjected to the natural 
changes that occur in it on account of time after leaving 
the cow and the agitation of transportation; vegetable 
food is obtained before it undergoes retrograde meta- 
morphosis. The opportunities for out-door exercises 
are greater, etc. The disease frequently occurs about 



DISEASES OF CHILDREN 395 

the time of weaning or when young children are sub- 
jected to a change of food which, combined with other 
causes, are sufficient to develop it. Even when fed upon 
its mother's or the nurse's milk, unhygienic surround- 
ings, dietetic or sexual imprudence may cause such a 
change in the milk as to be exceedingly deleterious to 
the child and thus, aided by other causes, induce an 
attack of this disease. The mother's or nurse's milk 
even while plentiful, may be so impure or impoverished 
as to be a source of the disease. 

Nursing bottles, unless cleansed at regular intervals 
with the greatest care, develop disease germs with 
great rapidity and are a great abomination. The more 
complicated they are the more difficult they will be to 
cleanse and consequently the worse for the child. 
Inpure air, often the result of decaying matters preg- 
nant with disease germs, is not backward in its contri- 
butions to the development of the scourge. 

Symptoms. — Necessarily, the symptoms of this dis- 
ease vary. Vomiting and diarrhoea, however, being 
present in all cases, but in variable severity. These, 
with the intense thirst, the great prostration and rapid 
emaciation furnish us with means of diagnosis, however 
much the other symptoms may vary. There may be 
an increased irritability of the child with diarrhoea for 
several days, but attracting little attention. This may 
increase slowly, the nausea, vomiting and thirst grad- 
ually developing. In other cases the attack comes on 
suddenly and is severe at the outset. 

The passage from the bowels at first contains fecal 
matter, little odor or perhaps a sour smell, but, as a 
rule, they are very offensive, the odor sometimes pene- 
trating every part of the house. The stools frequently 



396 PAINLESS CHILDBIRTH 

contain partially digested food mixed with stringy 
mucus, yellowish, greenish or clayey in color, or are 
perhaps almost white with curds of undigested milk 
and sometimes streaked with blood. In other cases 
the stools are watery, and it is not unusual to see them 
change rapidly, presenting all these peculiarities in 
turn. The thirst is intolerable, incessant, and the fluids 
taken are almost immediately rejected or discharged by 
the bowels. The child is uneasy, restless, never satis- 
fied, desiring constant change, or it may lie semi- 
stupefied, roused at intervals by paroxysms of pain 
that seem to resemble the pains of cholera morbus, 
the child suddenly screaming and then lapsing into 
the stupor again. 

The nervous system is very irritable and often disease 
of the brain complicates the case. 

As the disease progresses, the eyes become sunken 
and partially closed, the lips are dry, parched, bleeding, 
the countenance pale, the skin dry and pinched and 
rapid emaciation takes place. The bowels are tender. 
An eruption often appears upon the buttocks or, ex- 
coriated by the discharges, contact with the stools or 
urine occasions great smarting, and pain is materially 
added to the child's suffering. 

The pulse is small, quick, tense; the tongue at first 
coated with a whitish fur, becomes dry and glossy. 
All the symptoms are generally worse at night and a 
remission towards morning apt to occur, but rapid 
changes are likely to take place at any time. 

When the brain is affected, the head becomes hot 
and is rolled from side to side, or the child sinks 
into a stupor, the eyes rolled upwards, the lids but 



DISEASES OF CHILDREN 397 

partially closed, the pupils dilate and do not contract 
on exposure to the light. 

There may be as many as fifty stools in twenty-four 
hours, but, as a consequence when so frequent, the 
quantity at each passage will necessarily be small. 

Sometimes the disease assumes a more chronic form 
and the symptoms are not so severe, and some of them 
may be absent, but the vomiting and diarrhoea reduce 
the child to a skeleton, the skin becomes dark and harsh, 
with livid spots, the mouth filled with apthous ulcera- 
tions, the tongue swollen or perhaps shrunken and the 
stools acrid and offensive. In such cases, acute symp- 
toms or disease of the brain are sometimes developed 
and destroy the child. The disease may last from three 
days to two weeks, leaving the child in a broken-down 
condition from which it will require months to recover. 
In others the alternate periods of getting better and 
worse will protract the case for weeks and even months. 
Absolute safety from a relapse is never certain until 
the warm season is passed and the cool weather is 
accompanied with a complete convalescence; and 
even then there is no immunity against a recurrence 
the next season, except the child be over two years old, 
when there is comparative safety. 

Treatment. — Reference to medical writings will 
convince the reader that the profession is at sea in 
this complaint, and it is no wonder with this experience 
many prefer to rely on the nursing and care of "grand- 
ma" or " aunty" instead of resorting to "doctor's 
stuff." 

Pure air is essential and a removal to the country, 
particularly an elevated situation, is desirable. This 
cannot always be done and in cities every effort should 



398 PAINLESS CHILDBIRTH 

be made to render the air as pure as possible by the 
removal of everything offensive; avoid dark, damp 
rooms and secure plenty of sunshine, even though the 
heat has to be modified by shades, but with the sun- 
shine secure constantly changing air. Allay the inor- 
dinate thirst by a spoonful of cold water; it is very 
grateful and, though too much will be rejected, small 
quantities repeated often are generally acceptable. 
Small bits of ice dissolved in the mouth are beneficial. 
The ice must be clear and pure; repeat the bits often; 
break them so fine that if swallowed they will not do 
any harm. 

No time should be lost in calling a physician to treat 
an infant or child suffering from an attack of diarrhoea. 
If for any reason his visit is delayed all breast 
nursing or bottle feeding should be stopped for from 
twelve to twenty-four hours and some egg or barley 
water given instead. A dose of castor oil and a warm 
rectal injection of soapsuds will help nature to get rid 
of the irritating and poisonous substances in the bowel. 
The following powder given every three hours will 
often check the diarrhoea: 

Salol, . . . Y2 grain 

Subcarbonate of Bismuth, . . 2 grains 

Lime water may be added to milk advantageously 
in the proportion of an ounce to a pint. See that the 
nursing bottle is thoroughly cleansed and scalded after 
each feeding. Diminish the quantity of food from that 
taken before the sickness began and give it only at 
intervals of two to four hours. Sometimes the milk 
will be rejected by the stomach because it is too rich 
in fatty matter; in such cases skim it, but do not go 



DISEASES OF CHILDREN 399 

to the other extreme and starve the child on the shadow 
of milk. 

In older children the juice of raw meat is sometimes 
very acceptable and better than milk; add a little 
salt to it to make it palatable and give half to one tea- 
spoonful every two hours. Carefully watch all food 
and if it disagrees set it aside. I have seen weak mutton 
broth agree nicely sometimes when other food was 
rejected. I have seen skimmed milk accepted and agree 
well when unskimmed was loathed and rejected. This 
is not apt to happen in cities. There are many artificial 
foods in the market, but of their relative value I am 
not prepared to speak. When tried, it should be cau- 
tiously and under advisement of a physician. The 
digestive process being almost wholly if not quite 
suspended, there is usually more danger of overfeeding 
than starving the child. Small quantities digested do 
good, but large amounts are apt to undergo fermen- 
tation and add to the existing trouble. 

Bathing is not to be omitted. If the child is feverish, 
restless, thirsty, tepid bathing is decidedly beneficial 
and should be repeated several times in twenty-four 
hours. A sponge bath is most proper and care should 
be observed that the clothing is not left wet. 

The removal of the discharges from the bowels 
should be effected immediately and disposed of so 
that no smell is left behind. As the buttocks are very 
apt to get sore, they should be dusted with powdered 
stearate of zinc or smeared with oxide of zinc ointment. 
Powdered starch or lycopodium is also good, and may 
be freely dusted on. 

The neutralizing cordial of the eclectic school is in 
great favor with many. I esteem it highly if the tongue 



400 PAINLESS CHILDBIRTH 

is moist with a whitish fur, the matter vomited sour 
or the stools clay colored, sour or curdy. For these 
cases I prepare it thus and consider it better than the 
usual preparation on account of the omission of the 
sugar, which is always in the preparation as usually 
obtained : 

Pulverized Peppermint Leaves, Y 2 dram 

Pulverized Rhubarb Root, . 1 dram 

Bicarbonate of Soda, . . 1 dram 

Boiling Water, ... 4 ounces 

Cover, let it stand until cool, strain and add half an ounce best 
brandy and give in teaspoonful doses every hour until its pecu- 
liar color is seen in the stools; then give it three times a day. 
The addition of one half grain of subnitrate of bismuth in each 
dose often materially enhances its value. 

When we have the vomiting under control, we have 
gained an important point. If the stools are copious, 
watery, offensive and apparently painless I would give 
two to five drops of the compound tincture of cinchona 
every three hours in a teaspoonful of water. When the 
discharges begin to yield, lengthen the intervals 
between the doses. 

If the trouble depends on irritation from teething, 
and the gums are hot and swollen, lance them and give 
in alternation with the neutralizing cordial above: 

Fluid Extract Gelsemium, . 10 drops 

Water (one half goblet), . . 4 ounces 

Dose — A teaspoonful every hour or two until the irritation 
of the nervous system is relieved. 

The use of pepsin in grain doses just before or after 
the feeding will aid the digestion of the food taken at 
that time and is a valuable auxiliary to other means. 

After the urgent symptoms are passed, a looseness 
of the bowels or a feebleness of the digestion often 



DISEASES OF CHILDREN 401 

remains. In such cases continue the pepsin at the time 
of feeding and also give three to five drops of compound 
tincture of cinchona in a spoonful of water about four 
times a day. This, however, may be replaced by hy- 
drastis in some form or other, of which the fluid with- 
out alcohol, five drops in two ounces of water given 
in teaspoonful doses three or four times a day, answers 
a good purpose. 

I might add fifty or more other remedies, but as 
they would be more apt to mislead than aid I omit them. 
Many cases will occur which in the judgment of the 
attending physician require that other remedies should 
be given. 

WORMS 

Several varieties of worms infest the intestinal canal, 
but children are specially liable to the round or stomach 
worm (Ascaris Lumbricoides) and the small white or 
pin worm (Oxyuris Vermicularis). The round worm 
(Fig. 39) is smooth, light brown or reddish in color, 
about as thick as a slate pencil, tapering at each end 
and from five to ten inches long. Pin worms are very 
common in children between three and ten, and while 
usually there are from two to ten present there 
maybe hundreds. Round 
worms infest the small 
bowel. The pin worm 
(Fig 38) is about one 
third of an inch long and 
looks like a little piece 
of white thread. It in- 
habits the rectum and 
lower bowel Figure 38 




402 



PAINLESS CHILDBIRTH 



Figure 39 



The symptoms they occasion 
are variable; usually there is a 
malnutrition and a catarrhal con- 
dition of the bowels, plenty of 
mucus being favorable to their 
development. The appetite is 
capricious, sometimes absent and 
sometimes voracious, the breath 
offensive, acrid eructations, colicky 
pains about the navel, sometimes 
vomiting and diarrhoea, slimy 
stools, profuse urine, grinding the 
teeth, sudden starting in the sleep, 
picking the nose, fever, emacia- 
tion, hacking cough, irregular 
pulse and sometimes convulsions. 

In addition to these symptoms, 
when pin worms infest the lower 
bowel there will be an intolera- 
ble itching of the anus with slimy 
stools, etc. All these symptoms 
may be present and yet we can- 
not be absolutely certain that 
they are due to worms, unless we 
see them or pieces of them in the 
stools. Occasionally, however, they 
will be vomited up or crawl from 
the mouth., In little girls pin 
worms will sometimes find their 
way from the rectum into the va- 
gina and give rise to troublesome 
itching and leucorrhoea and some- 
times irritation of the bladder, 



DISEASES OF CHILDREN 403 

Treatment. — The indications are to destroy the 
parasites and improve the condition of the intestinal 
tract so as to prevent their reproduction. Worms are 
exceedingly prolific, and children of a scrofulous dispo- 
sition and those indulged in an excess of sweets or fed 
on unwholesome food will be very apt to suffer from 
frequent repetition of the symptom unless the treat- 
ment to destroy them is repeated at intervals and an 
improvement in the intestinal condition effected. For 
the first indication we have several remedies, even the 
common pumpkin seed is a good one. It may be eaten 
by the children or steeped and the tea drank. The old 
fashioned infusion of pink root and senna is an effec- 
tual remedy in doses of one half to one teaspoonful for 
a child of two years. Turpentine fulfills the indication 
well, fifteen to twenty drops of spirits of turpentine 
in a dose of castor oil repeated every third day does 
well. Salt water gives temporary relief. I like the 
following : Take 

Santonine, .... 10 grains 



Podophyllin, 
Bicarbonate of Soda, 
Sugar, 



2 grains 

30 grains 

1 dram 



Another good method is this: Give the child (six 
years old) a glass of milk only for supper and at bed- 
time a powder containing one half grain each of calomel 
and santonin for three nights. 

I have seen this plan do wonders for children some- 
times. When convulsions occur, in addition to the use 
of the "worm medicine/ ' give such treatment as is 
advised under the head of convulsions. 

The pin worms infest the lower bowel and remedies 
administered by the mouth are of little consequence. 



404 PAINLESS CHILDBIRTH 

To effectually destroy them it is necessary to apply the 
remedies directly. Injections are required and a strong 
solution of salt and water is very effectual. An infusion 
of ground quassia chips (one ounce of quassia in one pint 
of hot water) is good, or fifteen drops of carbolic acid 
in a, goblet of warm water may be used. 

Whichever injection is selected should be used after 
the turpentine and oil or santonin and podophyllin 
have acted on the bowels and it should be repeated 
every two or three days until they are entirely de- 
stroyed. In using injections, let the quantity be suffi- 
cient to distend the folds of mucous membrane of the 
rectum and reach all the hiding places of the parasites, 
or they will speedily be reproduced. At least half a 
pint should be used at a time, but not sufficient to 
distend the bowels so much as to cause the child severe 
pain. The injection is to be retained a few minutes if 
possible. 

This plan of treatment, simple as it may seem to 
some, will be found efficacious and has the advantage 
of being available under nearly all circumstances. 

The itching caused by pin worms may usually be 
overcome by applying cold cloths or mercurial oint- 
ment to the anus. Cleanliness of the parts is all impor- 
tant. 

Although we have already exceeded the intended 
scope of the present edition, the author realizes that 
there are many other subjects deserving consideration 
that must be left to the future. Still, if the directions 
already given shall enable woman to find even partial 
relief from sickness and pain and render her assistance 
in the preservation of her darlings and the promotion 
of their welfare, his object will have been accomplished. 



CHAPTER XIX 



CARE OF THE SICK 
foods and medical formulae 

Sponge Bath 

Plain water or equal parts of water and alcohol, or 
water and vinegar may be used. The temperature of 
the water should be 85° F. to 90° F. Remove all cloth- 
ing (in infants except the diaper) and sponge one part 
of the body at a time, the rest of the body being kept 
covered. The sponging should last for five to fifteen 
minutes, and the child then wrapped in a blanket 
without any clothing. 

Mustard Bath 

Stir four or five tablespoonfuls of mustard in one 
gallon of tepid water and then add four or five gallons 
of water the temperature of which is 100° F., as ascer- 
tained by the bath thermometer. By adding more 
hot water the temperature can, if desired, be raised 
to 105° F. or 110° F. This bath is very useful in heart 
failure, shock, collapse, congestion of lungs or brain. 
The mustard bath- should not usually last longer than 
ten minutes, wiien the child is quickly removed and 
wrapped in a blanket, without drying. 



406 PAINLESS CHILDBIRTH 

Mustard Foot Bath for a Child 
Protect the bed with rubber sheet covered with 
towels. Cloths are wrung out of mustard water, made 
by adding one teaspoonful of mustard to a quart of 
water heated to 110 F. Wrap these cloths about the 
child's feet (keeping the rest of the body covered) and 
apply until the skin becomes red. 

Mustard Plaster or Paste 

For adults this is made of pure mustard, or of equal 
parts of mustard and flour freed from lumps, mixed 
into a paste with tepid water and spread between two 
layers of muslin or soft linen. The object of the flour 
is to prevent blistering, and in its place corn meal, 
vaseline or the white of egg may be used. For children 
the proportion should be one part mustard to from 
four to eight parts flour. The mustard plaster is ap- 
plied to the part, covered with a towel and allowed to 
remain in place until the skin is well reddened — usually 
ten to twenty minutes. A corner of the plaster should 
be raised from time to time to see that it is not blister- 
ing. After the plaster has been removed the skin should 
be well cleansed, smeared with vaseline, oil or lard and 
covered with a soft cloth. 

Hot Water Fomentations 
Place a piece of flannel or blanket (preferably white) 
of the size required in the middle of a large towel and 
dip it in a basin of boiling water until thoroughly 
soaked. Twist the ends of the towel to thoroughly 
wring out the water, unfold the towel, shake out the 
flannel, apply it to the affected part, cover it with dry 
flannel or towels and rubber sheeting and apply a 
bandage to retain it in place. 









CARE OF THE SICK 407 

Spice Plaster 
Thoroughly mix equal parts of allspice, cloves, cin- 
namon and nutmeg and add one half part of black 
pepper. Place in a muslin bag, quilted to prevent sag- 
ging. Moisten one side of the poultice with warm 
brandy or whisky and apply to part desired. When the 
skin is tender, the amount of cloves and black pepper 
should be decreased. A spice plaster may be allowed 
to remain in position for hours, and is by many consid- 
ered a very useful application in some forms of stomach 
and bowel troubles in children. 

Turpentine Stupe 

Sprinkle about thirty drops (for children ten or 
fifteen) of turpentine over a piece of flannel wrung 
out of boiling water. A better way is to soak the piece 
of flannel in a pint of boiling water to which two or 
three teaspoonfuls of turpentine have been added. Take 
out the flannel, wring thoroughly and apply. 

Another method is the following: Place a tin cup 
containing the turpentine in a vessel or dish of hot 
water so that the turpentine may be warmed without 
coming near the fire. Dip a piece of flannel into very 
hot water, wring it so dry that no water drips from it, 
dip it into the hot turpentine and wring it again to 
free it from any excess of turpentine. The flannel 
while hot is then applied, but should not be left on too 
long, as it might blister. 

Flaxseed or Linseed Poultice 

Two and a half cups of meal and three cups of water 

will be required for a poultice for the chest or back. 

Add the meal to the boiling water, stirring all the time 

with a knife or spoon, When the mixture is just thick 



408 PAINLESS CHILDBIRTH 

enough to drop from the spoon, remove from the fire, 
beat it well and spread it evenly, about a quarter of an 
inch thick, on muslin or soft linen, leaving a two-inch 
margin to turn back. Before applying the poultice 
hold it to the face to see that it is not too hot. Put it 
on slowly — a patient can stand a hotter poultice when 
it is let down a little at a time. The poultice should 
not be left on longer than one hour. After removing 
it dry the skin, and if no more are to be used apply a 
little oil, vaseline or lard to the skin, if irritated, and 
cover with flannel. 

Beef Essence 

Mince finely one pound of lean, juicy beef, put it 
into a fruit jar and cork tightly. Set the jar in a kettle 
of cold water over a slow fire and let it boil for three 
hours. Strain and season with salt and red pepper. 

Scraped Raw Meat 

Scrape the pulp from a good steak, season with salt 
and pepper to taste and serve as a sandwich between 
two thin lightly toasted slices of bread. 

Beef Broth 

Cut up one pound of beef, put it into one pint of 
water and allow to stand for four or five hours. Then 
cook over a slow fire for one hour and skim off the fat. 

Beef Tea 

(1). Chop fine or mince one pound of lean beef, 
put it with its juice into an earthen vessel containing 
one pint of tepid water and let it stand for one hour. 
Strain thoroughly and squeeze all the juice from the 
meat. Place on a fire and slowly raise just to the 
boiling point, stirring briskly all the time. Season 






CARE OF THE SICK 409 

with salt and pepper, and when giving the tea always 
stir up the sediment. 

(2). Chop up fine one pound of lean beef and put it 
into one pint of cold water, to digest, two hours. 
Simmer on stove for two hours, but do not boil. Make 
up for water lost in the evaporation by adding cold 
water so that one pint of beef tea represents one pound 
of beef. Squeeze the beef thoroughly, strain and flavor 
to taste. 

Flaxseed Tea 

Add three teaspoonfuls of flaxseed, not ground, and 
one half teaspoonful of extract of licorice to ten ounces 
of boiling water and allow the mixture to stand in a 
warm place for from one to four hours. Lemon juice 
and sugar may be added to improve the taste. 

Albumen or Egg Water 

Add the white of one fresh egg to one half pint of 
cold water previously boiled. Shake thoroughly for 
half a minute and it is ready to serve. Sugar, salt, 
cinnamon or brandy according to taste may be added 
if desired. 

Barley Water 

Put two good sized teaspoonfuls of well washed 
pearl barley into one pint of cold water in a saucepan 
and boil slowly down to two thirds. Strain. 

Rice Water 

Cover two tablespoonfuls of rice with boiling water. 
Boil five minutes, drain and throw water away. Cover 
with twx> quarts of boiling water and simmer gently 
until reduced to about one quart. Strain through 
gauze. If used alone add a little salt. 



410 PAINLESS CHILDBIRTH 

Rice Milk 
Add one tablespoonful of well washed rice to one 
pint of fresh milk and boil for an hour and a half. Rub 
it through a sieve, add two tablespoonfuls of granu- 
lated sugar, heat and serve. 

Oatmeal Water 
Put one tablespoonful of oatmeal flour in one pint 
of water and boil down to two thirds of a pint. Strain. 
Beaten white of egg may be added if desired. 
Oatmeal Gruel 

Mix two tablespoonfuls of oatmeal in a little cold 
water and add a quarter of a teaspoonful of salt. Pour 
over it one pint of boiling water and stir over the fire 
until it boils. Place it to one side where it will bubble 
slowly for half an hour; add a lump of sugar and a 
tablespoonful of whipped cream and serve. 
Arrowroot Juice 

Moisten a tablespoonful and a half of arrowroot in 
a little cold water. Pour over it a pint of boiling milk. 
Stir over the fire until it thickens and let it boil slowly 
for ten minutes. Remove it from the fire and add a 
teaspoonful of sugar and a quarter of a teaspoonful 
of salt. 

Junket 

Put a half pint of cold, fresh milk into a clean sauce- 
pan and heat it lukewarm (not over 100° F.) ; add one 
teaspoonful of essence of pepsin or liquid rennet and 
stir just enough to mix. Divide quickly into small 
cups or glasses and let stand until firmly jellied, when 
the junket is ready for use, just as it is, or with sugar, 
grated nutmeg, etc.; or it may be placed on ice and 
taken cold. 



CARE OF THE SICK 411 

Whey 
Put one pint of cold, fresh milk into a clean saucepan 
and heat it lukewarm (not over 100° F.) ; add two tea- 
spoonfuls of essence of pepsin and stir just enough to 
mix; let it stand until firmly jellied, then beat with fork 
until it is finely divided; now strain, and the whey 
(liquid part) is ready for use. Keep in a bottle or glass 
jar near ice. 

How to Fumigate a Sick Room After Contagious 

Disease 
Books, playthings, toys and articles of trifling value 
should be burned. Close all cracks and openings in 
the room by stuffing them with cotton or pasting paper 
over them. On a clothesline in the room hang all bed- 
clothing, rugs and draperies, and open all closets and 
drawers. Pillows and mattresses should be ripped open 
so that the sulphur fumes may have access to every 
part. In the center of the room place a washtub partly 
filled with water and in it put two or three bricks on 
which to put a small dish containing the broken roll 
sulphur saturated with alcohol. Now light the sulphur, 
close the door, keyhole and all cracks. At the end of 
twenty-four hours open the door and all windows, so 
as to thoroughly air the room for at least another 
twenty-four hours. All furniture, floors and walls 
should then be washed with a one-in-one-thousand 
solution of corrosive sublimate. 

Neutralizing Mixture 
This valuable preparation, so much in use by the 
eclectic school, for dysentery, cholera morbus, diar- 
rhoea, vomiting, etc., is variously prepared by differ- 
ent physicians. The following formula will be found 



412 PAINLESS CHILDBIRTH 

convenient and efficacious. The pulverized peppermint 

leaves, from the plant gathered fresn each year, will 

be found preferable to the oil or essence. Take: 

Indian or Turkey Rhubarb, . 1 ounce 

Bicarbonate of Potassa, . .1 ounce 

Peppermint Leaves, Pulverized, . J^ ounce 

Mix. Put it in a covered stone or porcelain jar, and 
add a pint of boiling water. When cold add one half 
pint of best brandy and one half pound of loaf sugar. 
Let it stand a day or two and then strain through cloth, 
and bottle. 

Dose — For an adult a tablespoonful every half hour. 
For a child two to four years old a teaspoonful every 
two hours. 

Some add cinnamon and cloves to the above formula, 
but I do not know that they increase its efficacy. 

The bicarbonate of soda may be substituted for the 
potassa if necessary. 

Mothers will find this an excellent preparation to 
have at hand for the stomach and intestinal disorders 
to which every one, large and small, are liable. It will 
keep indefinitely. 

Acute Laryngitis, Hoarseness, Etc. 

Compound Tincture of Benzoin, 2 ounces 

(Friar's Balsam) 
Directions — Put two teaspoonfuls in a pitcher containing one 
pint of boiling water, throw a towel over the head, hold face over 
pitcher and inhale the fumes. 

Dobell's Solution 



Borax, 


1 dram 


Bicarbonate of Soda, 


1 dram 


Carbolic Acid, . 


J^ dram 


Glycerine, . 


1 ounce 


Water, .... 


1 quart 



A useful wash for nose and throat in catarrhal affec- 
tions; should be used with an atomizer. 



CARE OF THE SICK 413 

A Calomel Purge 

Calomel, . . . . J/£ to 1 grain 

Sugar of Milk, .... 10 grains 
Divide into ten powders. 
Directions — One powder every half hour or hour until all 
are taken. 

A Useful Mixture for Fever in Children 

Citrate of Potash, ... % dram 

Sweet Spirit of Nitre, . . \Yi drams 

Orange Syrup, to make . . 2 ounces 

Dose for Child One Year Old — One teaspoonful in one 

teaspoonful of water every three hours. 

Sore Throat — Tonsilitis 

Chlorate of Potash, ... 2 drams 

Bromide of Potash, . . . 2 drams 

Tincture of Chloride of Iron, . 2 drams 

Extract of Licorice, ... 1 dram 

Water, to make ... 6 ounces 

Dose for an Adult — One teaspoonful in water every two 
hours; gargle and swallow. 



414 PAINLESS CHILDBIRTH 



When to Use Dr. Dye's Mitchella 
Compound 

WHEN young girls are just reaching maturity and merging 
into womanhood, and nature unaided is unable to perform its 
new functions, Mitchella Compound, by giving tone and strength 
to the distinctly female organs, allows the menstrual periods to 
recur regularly and without pain. 

WHEN menstruation is disordered and is either painful, scanty, 
profuse, premature, delayed, suppressed or irregular, Mitchella 
Compound will quickly remove the cause, correct the difficulty 
and allow the functions to be performed naturally, regularly 
and painlessly. 

WHEN, owing to neglect or to insufficient or improper treat- 
ment, you are suffering from female weakness in any of its varied 
forms, Mitchella Compound will make you well. Under its won- 
derful influence the female organs are made healthy, normal and 
strong, and those annoying symptoms — backache, sideache, 
bearing-down, prolapse, dragging and wearing pains, irregular 
or painful menstruation, leucorrhcea (whites) — quickly disap- 
pear; the nervous system is toned and strengthened, and the 
prostration, nervousness and exhaustion vanish as if by magic; 
the stomach, kidneys and bladder are freed from all traces of 
disease and, as a result, the symptoms of dyspepsia (such as 
pain in stomach, wind, bloating, vomiting, etc.), the symptoms 
of diseased kidneys or bladder (such as painful and irregular 
urination, getting up at night, swelling of the feet, etc.), rapidly 
disappear. 

WHEN you wish to prevent pain during pregnancy and at 
the time of confinement, take Mitchella Compound. The many 
annoying symptoms which occur during pregnancy and at con- 
finement are due to abnormal or diseased conditions of the female 
organs. Mitchella Compound, by removing all traces of disease 
in these parts and restoring all the parts to a normal, healthy 
state, prevents pain and makes childbirth easy and natural. 

WHEN you wish to prevent miscarriage, which is almost 
always due to disease of the womb or ovaries, the use of Mitchella 
Compound will always be found satisfactory. 

WHEN you wish to hasten recovery after confinement, take 
Mitchella Compound. Do not .forget that almost all cases of 
female weakness result from carelessness after confinement. 
Prevent all future suffering and aid the female organs to return 
to their normal condition by using two or three packages of 
Mitchella Compound. 



TESTIMONIALS 415 

WHEN you wish to have healthy, robust and strong children, 
tone and strengthen the womb by using Mitchella Compound, 
so that the unborn babe may be nourished with healthy, life- 
giving blood. 

WHEN you are passing through the " change of life, " Mitchella 
Compound by its tonic influence will prevent or remove all 
those nervous sj-mptoms which are so prone to occur at this 
time, and by its tonic and disease-removing effect on the female 
organs remove tendency to malignant diseases (cancer, etc.), 
which are so frequent at this stage of life. 

WHEN you consider yourself sterile or barren and are anxious 
to become a mother, let Mitchella Compound show its virtue. 
Sterility is always due to abnormal or diseased female organs. 
Mitchella Compound makes these parts healthy and free from 
disease, and childbearing then becomes a possibility. 

WHEN you are harrassed by kidney or bladder disease, do 
not forget that the trouble is almost always due to the pressure 
of diseased female organs. Mitchella Compound cures these 
diseases, and the symptoms of bladder and kidney disease quickly 
disappear. 

A WARNING. — For many years Dr. Dye's Mitchella Com- 
pound was the only preparation sold which was claimed to allay 
the pains of pregnancy and confinement. The praise and en- 
comiums which have been showered upon it by many thousands 
of women who have tested its virtues and merits have caused 
many imitations to spring up. These imitations are poor and 
worthless, and in no way resemble Dr. Dye's Mitchella Compound, 
either in composition or in results. Therefore, when ordering, 
see to it that you get the original Dr. Dye's Mitchella Compound. 

If you are still in doubt as to the worth of Dr. Dye's Mitchella 
Compound, write to one or more of the women whose testimo- 
nials we publish; always enclosing a stamped and self-addressed 
envelope. We are always willing and anxious to allow those 
women who have used it to speak the plain truth as to its worth. 

Price, $1. 00 per package, or six for $5.00. Sent prepaid. 
DR. J. H. DYE MEDICAL INSTITUTE, 
P. 0. Box 137. Lewis Block, Buffalo, N. Y. 



Unsolicited Testimonials 

Enclosed please find S5.00 for six boxes of your Mitchella Compound Tabules. 
Your Compound is a God-send to all expectant mothers. I took a three months' 
treatment before my baby girl was born. I can truly say I had no pain and she 
was born before my husband could go one mile and a half for my sister-in-law. 
She is a bright baby girl, one year, seven months old, and has never been sick 
an hour in her life. I always speak a good word for your Compound and wish 
all mothers knew about it. If my few lines of testimony will be of any use to 
you, you are welcome to publish it. 

Alma Center, Wis. MRS. JAMES A. ADAMS. 



416 



PAINLESS CHILDBIRTH 




Kindly send me a box of Mitchella Compound Tabules for the enclosed $1.00. 
I got three boxes two years ago and had a fine ten-pound baby girl. Never 
had no pain or ailments while taking the Tabules ; could do all my own work 
and never felt sick. I would never be without the Mitchella Compound Tab- 
ules any more, for they certainly helped me, along fine and I am recommending 
them where they are needed. 

812 Willow St., Scranton, Pa. MRS. JNO. F. EGEN, JR. 

I thought I would write and tell you how well I 
got along since I took your medicine. Just four 
weeks before I was confined, my four children and 
myself had the measles. When I took the measles, 
I never expected to get over them, and I baffled 
two good doctors how well I went through them. 
When confinement came, I was only in labor one 
hour and had only about four hard pains. The 
baby was a girl and weighed about seven pounds. 
I shall certainly always speak a good word for 
your medicine and tell all my lady friends that are 
in need of such a medicine about it. If you wish 
to use my name as a testimonial for it in Iowa, 
you are at liberty to do so. 
Baby Evans Udell, Iowa. MRS. BLANCHE EVANS. 

Please send me six boxes of Mitchella Compound Tabules for the $5.00 en- 
closed. This is not the first time I have used this great medicine. I took six 
boxes of the Compound about three years ago, with excellent results, and with 
very little trouble or suffering gave birth to a fine baby boy, weighing 14^ 
pounds. I have highly recommended your medicine to others of my sex, and 
you may publish my testimonial in reference to your great medicine, Mitchella 
Compound, if you so desire, as I would not be using this remedy again if I 
did not know it to be good and do just as it is claimed. 

Mulberry, Ark. MRS. NORA DUVALL. 

I began the use of Mitchella Compound in July and my baby was born 
October 3rd, a nine pound boy, very healthy. I was in labor only a little more 
than an hour — my doctor and nurse both considered it a very easy confinement; 
recovery rapid ; and I give Mitchella Compound and you the praise of making 
me a healthy woman. I suffered for nearly twenty-four hours when my first 
baby was born, and then I was put under the influence of chloroform and 
instruments resorted to. If you have no agent in this vicinity I would be glad 
for the chance to handle your remedies. I will answer all letters from women 
who wish to know more about my case. 

R. No. 1, Kingsley, Mich. MRS. JULIUS MIHULKA. 

I have been using your Tabules for my daughter 
and I use them for myself, and we thank you for 
your medicine. It did wonderful for us. I had 
five children before this one and always had such a 
hard time. This time I used your Tabules and got 
through in less than no time. I had no doctor. 
My husband had to assist, and my baby is big and 
fat. I send you his photograph. 




Pitman, Pa. 



MRS. CHAS. MORGAN. 



Baby Morgan 
to be an agent for your fine medicine 
Box 22, Pearland, Texas. 



I write you to let you know that I passed safely 
through my confinement and had a much easier 
time of it than I ever had before. The other time 
I was sick half a day and this time I was sick only 
half an hour and did not suffer as much as I did 
before. Our baby is a big, fine boy. I would like 
Please send particulars. 



MRS. I. M. ARMSTRONG. 



TESTIMONIALS 



417 




Baby Sorensen 



Will you kindly inform me if you still sell the Mitchella Compound, also 
give me the price of same. Twenty-three (23) years ago I used this Compound 
which was a great help to me, and as my daughter is now a prospective mother 
I would like to secure the same help for her. 

No. 7 So. loth St., Colorado Springs, Col. MRS. L. C. NISBETT. 

Enclosed please find money order for which send 
one box of Mitchella Compound Tabules. This is 
.for a friend. I took your Tabules about two 
months before confinement. The baby was born 
before the doctor got here, after less than two 
hours' pain. She is a fine, healthy baby, as you 
can see by picture I enclose. She is now three 
and one half months old. 

MRS. C. SORENSEN. 

3441 Calumet Ave., Chicago, 111. 

Enclosed find SI. 00 for one box of Mitchella 
Compound Tabules. Have taken four boxes and am 
in perfect health. They have helped me so much. 
MRS. LAURA WITHROW. 

218 Wheatland Ave., Logansport, Ind. 

You will find enclosed $1.00 for which send me one box of your Mitchella 
Compound in Tablet form, as I am nearly out. I used only two pack- 
ages and gave birth to an eight pound girl on November 17th and was not 
sick but about three and a half hours. I had the easiest time I ever had. I 
was always sick about a day and a night before. I have been sitting up ever 
since baby was three days old. I cannot praise your medicine enough. I suf- 
fered with cramps and varicose veins and could hardly walk, but they have 
all disappeared and I feel better than I ever did before. I will praise your 
medicine to anyone, and have recommended it to all my friends. 

R. No. 2, Nashville, N. C. MRS. J. M. TURNER. 

As I promised to let you know how I came through my confinement, I thought 
I had better write and let you know. Our baby weighed between seven and 
eight pounds when born. From the time I took sick until the baby was born 
it was only two hours and a half. I had an easy confinement. I was really 
surprised, because I never thought that a confinement could be so easy. I 
have good faith in your Mitchella Compound and shall tell other women about 
it. I am getting along well and so is my little boy. He is a healthy baby. If 
I ever get pregnant again I shall use some more of Mitchella Compound. 

Kevin, Mont. MRS. E. J. ENGLE. 

Through the kindness of my sister, Mrs. James 
Tharp, I was induced to take your treatment, con- 
sisting of four boxes, and to express my thanks and 
appreciation of your medicine, I am enclosing a 
picture of my baby girl, Waunetta, 12> l A months old 
the time the photo was taken. I must say she is 
the healthiest, smartest baby I ever saw and I give 
your medicine the credit. I have never been up 
a night with my baby and never had a doctor but 
once, and that was for a cold. She is one of the 
best babies I ever saw. There is no comparison 
with other babies whose mothers never used your 
medicine. Whenever I have a chance I will al- 
ways recommend your medicine. 

My sister has a little girl, four years old, who is 
considered a very beautiful child. She took your 
treatment, and my medicine was ordered through her. 
your medicine to my sister-in-law, and she has a fine healthy baby, 
sider your medicine a great help in childbirth, 

Fulton, Mo. MRS. JNO. L. DUNN. 




Baby Dunn 
I also recommended 



418 



PAINLESS CHILDBIRTH 



I used five boxes of Tabules and got along nicely. I think your Mitchella 
Compound is worth its weight in gold. I have a healthy baby boy. His weight 
is twenty-four pounds. 

Cannelville, Ohio. MRS. WARREN PLETCHER. 

Enclosed please find photograph of my baby. 
Before baby's birth I took your great remedy, Mit- 
chella Compound. She is now over two years old. 
When she was born she weighed sixteen pounds. 
I am again using your Compound to help and aid 
me through my present pregnancy and coming con- 
finement. 

MRS. E. E. CARTER. 

Grafton, W. Va. 

I used three packages of Mitchella Compound 

and can say I was well pleased with it. I only 
wished I had used more. I have a baby girl, four 
months old, weighed eleven pounds at birth. I 
shall recommend your medicine to all expectant 
mothers, as I am sure it is good. 

Oelwein, Iowa. MRS. A. D. O'NEEL. 







Baby Carter 



I thought I would write and tell you how I got along when I was confined. 
I just used one box of your Mitchella Compound, and when I received it I 
was unable to do my housework, was weak and all run down and had morning 
sickness very bad. I got relief from the first two or three doses of the Com- 
pound, went to work and did my household duties and washing for the family 
up to the very last. With my twins I was in labor about 48 hours, but with 
the last child I was in labor about 25 minutes and gave birth to a nine-pound 
girl. I had five labor pains. The baby is very healthy. Has had only one spell 
of sickness which was hives. She will soon be three months old. Your medicine 
is worth its weight in gold, and if ever I am in need of it again, you will receive 
my order. You may use my testimonial if you wish. 

R. No. 1, Box 148, Earleyville, Tenn. MRS. DELIA FOSTER. 

I suffered three days before the birth of my first baby. I had not then heard 
of your wonderful medicine, but before the birth of my second baby I took 
three packages of Mitchella Compound and was only sick a very short time. 
Baby is now two months old and very fat and healthy. I will always speak a 
good word for your wonderful medicine, as I know it saved me lots of suffering. 
You may print this if you wish and I will answer any letter of inquiry, enclosing 
a stamped envelope for the reply. 

Hawkeye, Mo. MRS. ZYLPHA STRUTTON. 

Inclosed you will find a picture of my baby. She 
was eight months old when it was taken. I took 
two boxes of Dr. Dye's Mitchella Compound 
Tabules and same helped me greatly. You may 
publish this picture if you wish. My baby is well 
and hardy. 

MRS. ALLEN HEAGY. 

Mount Joy, Penna. 

Your Mitchella Compound is certainly a wonder- 
ful medicine. With my last baby I was only sick 
three hours, and not so sick as with my two first 
children. The baby was a boy and he weighed 
seven pounds at birth, ten pounds at one month, 
sixteen pounds at three months. He will soon be 
four months old, and so far I have not lost one 




Baby Heagy 
hour of rest. He is a dandy. Success to you. 



Box "B," Robinson, Utah. 



MRS. LEONARD W. PECK. 



TESTIMONIALS 



419 



Enclosed you will find money order for SI. 00 for which please send me one 
package of Mitchella Compound in the tablet form. I have, and am at the 
present time, deriving much benefit from your medicine. I cannot praise it 
too much, as it certainly makes childbirth easier. 

239 11th St., Renova, Pa. MRS. GEORGE VAN RIPER. 



We have two little twin 
girls, six months old, and 
weighing twenty pounds 
each. I only took two boxes 
of your Mitchella Com- 
pound and did not have one 
pain. I thank you again 
for your great help. I send 
herewith the picture of my 
twin babies. 

MRS. MATILDA 

BELLOCK. 

Vilas, S. D. 




Mrs. Bellock's Twins 



I will write you a few words in praise of your Mitchella Compound. I have 
used it twice and cannot praise it high enough. Each time I was only sick for 
a few hours and suffered very little, and at other times I almost suffered death 
for two or three days and nights. I think your medicine makes healthy babies. 
I have a fine baby boy, five months old, weighs eighteen pounds. I never had 
a doctor either time and got along so fine. Never had any trouble. _ I know God 
will bless you for the help you have been to women. I have advised all preg- 
nant women of this community to use your medicine, and several have tried 
it and it has proved all you claim for it. I shall always praise Mitchella Com- 
pound. 

Pine Level, Fla. MRS. SARAH FORD. 



I will drop you a few lines to let you know how nicely I got through my 
dreaded confinement, and was up and around on the tenth day and felt real 
strong. I gave birth to a nice baby boy which weighed ten pounds. My attend- 
ing doctor was so surprised to think that I would get along so nicely on account 
of my age. I shall be pleased to recommend your Mitchella Compound and 
thank you for such a God-send to women in my case. 

Bonner Springs, Kan. MRS. J. C. VAN ZANT. 

I took your Mitchella Compound before my baby 
was born and got along very well. My baby 
weighed fifty-seven (57) pounds at eighteen (18) 
months old. Everybody says she is the finest baby 
they ever saw. A great many people come to 
town to see my baby. She is a show for every- 
body and the joy of our home, as you will readily 
see by the photograph I enclose of her. If you 
wish to use this letter, you are at liberty to do so. 
I am now on the road to motherhood again and, as 
I derived so much benefit from your Compound 
before, I wish to use it again. 

MRS. MAGGIE BAKER. 

Greenville, N. C. 

I will enclose S3. 00 for which send me three boxes 
of Mitchella Compound Tabules, for I cannot recommend them high enough 
for the good they have done for me. 

Cyclone, W. Va. MOLLIE BAILEY. 




420 PAINLESS CHILDBIRTH 

I will write to thank you for the good your Mitchella Compound did me. My 
baby was born March 18th, and everyone said I certainly had a fine time. 
Was only in pain two hours, and everyone predicted a hard time, and one good 
thing — I never suffered with anything before — not even morning sickness. I 
certainly have a fine baby boy — one who has never been sick a day. I am very 
glad I took the Compound. I am ordering one box now for a friend, which I 
hope you will send at once. 

424 Main St., Camden, N. J. MRS. J. C. SCHWENKER. 

I have used your Mitchella Compound and I think it has no equal for what 
it is recommended. 

Gorman, Tex. MATTIE B. SELLERS. 

Enclosed please find $2.00 for which send me two packages of your Mitchella 
Compound. 

Have used your medicine and think it is worth its w r eight in gold. 
Seneca Falls, N. Y. MRS. H. B. EDKIN. 

After so long a delay I will write and let you know how your medicine has 
benefited me. It did me, I must say, a world of good. Baby weighed 10^ pounds 
and the brightest babe we ever had. I had an easy and short labor — was only 
sick 23^ hours, when I was always before from six to nine hours. My baby 
weighed 19M$ pounds at 63^ months old. I have recommended the Compound 
to several women who are now taking it. I feel very grateful for what your 
medicine has done for me. 

Box 136, Cameron, W. Va. MRS. BERTHA HIBBS. 

I will try and write you this evening and tell you what your wonderful 
medicine did for me. I took three boxes of your Mitchella Compound and had 
an easy time at confinement. I was not sick but four hours and I was not in 
labor fifty minutes. My baby is a fine healthy girl. I can gladly recommend 
your medicine to all suffering women. I had a box of the Tabules to take after 
the baby was born, but I feel so well I do not think I need the medicine. I 
had no faith in your medicine when I saw your advertisement in the paper, 
but it is just what you claim it to be. I was always sick and feeling bad through 
pregnancy until this time — I felt fine. I can never praise your medicine enough. 

Tokio. Ark. MRS. ZADIE ASKEW. 

Too much cannot be said in favor of Mitchella Compound. It will do all 
it is claimed for. I took five packages before confinement and one after. I 
did not suffer any to speak of — I was on my feet until the last minute. I rushed 
them to fix my bed, laid down, had three pains and I gave birth to an eight- 
pound boy. I surprised them all. This is my fourth baby and I always suffered 
before. I got up the seventh day feeling strong. I never got up before before 
the eleventh day, then had to be held so I wouldn't faint. I am stronger than 
ever before, doing all my own work since baby is fourteen days old. You can 
print this and, if anyone doubts it, they can just write me, enclosing postage, 
and I will answer all inquiries. 

I also have a copy of your book Painless Childbirth and think it grand. I 
left two others read it and they say the same. 

R. No. 1. Knierin, Iowa. MRS. GEO. I. WILHELMS. 

I want to tell you what a great help your Tabules have been to me. I only 
used one and one half boxes and gave birth to twin babies, a boy and a girl. 
The boy weighed ten pounds and the girl eight pounds. They have never been 
sick a day. I did not have a half hour's pain and did not have a doctor. Every- 
thing was over with so quick. I would have been all alone but for the aid of 
the telephone and automobile, and every time before I was so slow and helpless 
that the neighbors were afraid to be near me, and even then I would have a 
doctor, and after all my sufferings at confinement, and months of suffering 
before, I would lose my babies. I wish every suffering sister could only have 
seen what a miracle your Tabules worked for me. It is the wonder of every- 
one who hears about it. I was able to do all my work and was just fine after 
my babies were born. I could have gotten up and took care of them so far as 






TESTIMONIALS 421 

strength was concerned. I am trying to get more suffering sisters to try your 
Tabules. Oh, how welcome the word "confinement" would sound to all sisters' 
ears if they would try your miracle-working medicine. They will have to try 
it to find out how good it is, as its goodness cannot be spoken in words good 
enough. If you wish to use my name in regard to the benefit your medicine 
does, you are welcome to do so. 

R. No. 1, Oak Hill, Kans. MRS. CHRISTINA A. NOLAND. 

Enclosed find $1.00 for which please send me one box of your Mitchella 
Compound Tabules. I have taken four boxes of your Mitchella Compound 

and find it a great benefit. I have a fine boy five days old. I only remained in 
bed two days, and when baby was born I only had two pains worth speaking 
of. He is the largest and healthiest one out of my four, and has been no trouble 
so far. I am feeling fine. Many thanks to you. 

R. No. 5, Marshall, N. C. MRS. SARAH FRISBEE. 

Enclosed find money order for SI. 00, for which please send me one package 
of Mitchella Compound. I took the last of the Compound one month ago and 
cannot do without it. I have a fine boy two months old — he weighed nine pounds 
at birth. I think your Compound a wonderful medicine. 

R. No. 8, Box 7, Columbia, Tenn. MRS. FRANK HAMMON. 

Although my baby is seven months old I feel that I ought to write you what 
Mitchella Compound has done for me. After undergoing terrible suffering at 
two previous confinements where instruments were used, losing both babies, 
at this birth I was sick just one hour and twenty-five minutes and gave birth 
to a five-pound baby girl. I was up on the sixth day and felt fine. My baby is 
well and strong, weighing sixteen pounds now. I have persuaded several to use 
your medicine, with good results, and am now sending for three one dollar boxes 
of the Mitchella Compound Tabules for a sister of mine. 

You are at liberty to use my letter if you wish. 

Blencoe, Iowa. MRS. W. C. ISOM. 

I have used your Mitchella Compound before the birth of each of my three 
children and have been able to work and do everything just the same as usual. 
Never have any .kind of sickness and scarcely any pain at confinement. Chil- 
dren are fat and healthy. 

Shellsburg, Iowa. MRS. ANNA KING. 

I feel it my duty to give you my testimonial. You may publish it if you wish. 
In April, 1903, I became pregnant and my condition was such that I had to 
take to my bed. After three months of severe suffering and after all other medi- 
cines had failed, Mitchella Compound almost raised me from the dead. I would 
not be without it at that time for five times its cost. 

R. No. 2, Fyffe, Ala. MRS. CORA GRAVES. 



422 PAINLESS CHILDBIRTH 



Are You Afflicted with Any Kind of 
Chronic Disease? 



For nearly a quarter of a century I have been in- 
vestigating and treating all forms of obscure, delicate, 
chronic diseases. During this time I have developed 
a system of treatment and discovered remedies with 
which I am able to cure, even after other remedies 
have been used in vain, all such obstinate, lingering 
maladies of both sexes as kidney and bladder diseases, 
chronic nasal catarrh, asthma, bronchitis and incipient 
consumption, diseases of the heart, liver and nervous 
system. All blood poisons, rheumatism, gout, neural- 
gia, epilepsy, Saint Vitus' dance, spinal irritation, 
paralysis, all forms of diseases peculiar to women, as 
well as the ailments incident to men — spermatorrhoea, 
impotency, strictures, etc., etc., etc. 

By the method now pursued by me, all cases not 
requiring surgical treatment can be cured at their own 
homes with small expense. 

I cordially invite all afflicted persons, no matter 
what the nature of their ailments may be or of how 
long standing or what treatment they may have tried 
in vain, to write me. I make no charge for such con- 
sultation and they may write me fully and freely in 
perfect confidence. No one sees their letters but 
myself, consequently any secret they confide in me 
will be perfectly safe. 



TESTIMONIALS 423 

The first step towards a cure is a correct diagnosis; 
this I can make without difficulty if the patient will 
answer my questions carefully. To enable them to do 
this I will send examination blanks to those desiring 
them. If on their return I find additional questions 
necessary, I will ask them, until I obtain the necessary 
information. Analysis of the urine will be made when- 
ever it can be of advantage or benefit to the patient 
or necessary to complete my diagnosis. 

Diagnosis is both a science and an art — qualifications 
all do not possess, by any means, or there would be 
fewer mistakes and more cures. My methods are 
based upon scientific principles and are successful. I 
begin right, and then spare no pains for my patrons' 
benefit. 

Occasionally there is a physician who will advise 
patients against being treated at a distance, but it 
is either because they are ignorant of the method 
pursued, bigoted or jealous. Sometimes they will 
appeal to the patients' incredulity, but there is usually 
a selfish motive in it, which a few have even carried so 
far as to prefer their patients should never get well 
than that somebody else should cure them. My 
experience extends over many thousands of cases in 
which every conceivable manner of complications 
existed. My opportunities have been practically un- 
limited and certainly far better than one whose practice 
has been confined to a certain locality, and in this 
regard the aphorism that " practice makes perfect" 
is true if it ever is. 

I can furnish the very best kind of references as to 
my qualifications and integrity, but I want all to in- 
vestigate for themselves. If, on investigating any 



424 PAINLESS CHILDBIRTH 

case submitted to me, I find it incurable, I will tell 
the patient candidly his or her condition. 

Afflicted Reader, I offer you health. I can cure 
you if it is in the range of human possibility; but, 
remember, chronic diseases are progressive, they 
thrive by neglect; therefore, do not procrastinate. 
Write me freely; it will not cost you anything and 
may save your life. If the experience of a quarter of 
a century counts for anything it is in your favor. 

In writing me be explicit. Describe all the symptoms 
you experience. It is my province to unravel the 
tangled skein of pathological derangement. Describe 
your ailments in your own language and I will under- 
stand it and use it to your benefit 

Address all communications plainly and they will 
receive prompt attention. 

Respectfully and sincerely yours, 

JOHN H. DYE, M. D., 

Buffalo, N. Y. 



A Few Testimonials From Grateful 
Patients 

Sterility. 

I want to let you know what your special treatment did for me. You can 
use this for a testimonial if you so desire. I am now pregnant just sixteen weeks. 
I have no more indigestion or pain and am gaining in flesh. I have told several 
of my friends and they can hardly believe it, as 1 have been married seven 
years this January and never had a child. I am glad, however, to say that I 
am now on the road to motherhood. 

Box 102, Hewlett, N. Y. MRS. L. GANGLOFF. 

I have taken your medicine about nineteen (19) years ago in the Change of 
Life. I am now fifty-six (56) years old and never see a sick day and never have 
an ache or pain. Before I took your treatment I was never well and was 
always troubled with constipation, and since I have taken your treatment I 
have never been troubled with this ailment. Would advise both young and old 
to try Dr. J. H. Dye's cures for all ailments of the body. 

Chester, W. Va. MRS. M. E. RUSSELL. 



TESTIMONIALS 425 

Sterility. 

After taking your special treatment I find that I am now about five months 
along on the road to motherhood. I have not had one sick morning. 
Milford, Cal. MRS. G. R. WALES. 

Rheumatism, Constipation, Catarrhal Congestion of the Stomach. 

I enclose money for another month's special treatment, the same as you last 
sent me. I am very much improved and have not been as well in twenty years 
as I am now. 

R. No. 5, Dover, Del. MRS. MARY M. FAULKNER. 

Weak Nerves, Leucorrhcea, Backache, Displacement of the Womb. 

I was very glad to hear from you and still gladder to get the treatment. 
Doctor, I am still improving in every way and I am so thankful to you and to 
your fine treatment. All praises to you and I praise you from the depths of 
my heart. I have told all of my friends who are suffering from womanly ail- 
ments what you have done for me, and I will do my best to get them to try 
your treatment. 

Box 127, Dardanelle, Ark. MRS. WM. HELM. 

Painful Periods, Leucorrhcea, Headache, Female Weakness. 

I will write you to let you know how I am getting along. I just feel fine. I 
feel like a new person altogether. Before taking your medicine I suffered ter- 
ribly at the time of my monthlies, but this time I hardly knew I was that way. 
I am able to do my own work without feeling a bit tired, while before I could 
hardly sweep the floor. You are at liberty to use my testimonial if you like. 

R. No. 2, North Liberty, Ind. MRS. NANCY BARTON. 

Rheumatism, Congestion of the Kidneys. 

I had rheumatism in the ankles so bad that I could not sleep at night because 
I was in so much pain. I used your special remedies for one month and they 
helped me wonderful^. My ankles are not nearly so painful now. Many thanks 
for your medicines. I will recommend your medicines to all. 

Box 14, Riverton, N. H. MRS. JNO. E. DEERING. 

This is to certify that one year ago I was suffering untold misery and had 
been for seven months. I had rheumatism, nervous neuralgia and sudden cold. 
They had three different doctors with me, but they and all other medicines failed 
to do me any good until your agent, Mrs. Maggie Gary, came along with your 
medicine, which began to help me at once. Gentlemen, I cannot describe how 
I suffered those terrible months. I had given up all hope, my people and friends 
also had lost all hope. When I began using your medicine I was so near gone 
it did not look as if I could live from one minute until the next. I was so nerv- 
ous I could not hold still on the bed. I thank you a thousand times for the 
wonderful good your medicine did me. I cannot praise it as much as I want 
to, for I believe if it had not been for your medicine I would have been in my 
grave. May God bless you and may you succeed in the good work you are in 
is my earnest prayer. If you like, you may print this, as I would like every 
suffering girl and woman in the country to know how I have suffered and how 
I was benefited by your medicine. 

Smith, W. Va. MISS SARAH F. ALBRIGHT. 

I am only glad, too glad, to write a testimonial and let others know my case. 
I owe my health and happiness to Dr. Dye's Mitchella Compound and Female 
Cones. I have been married going on seven years, and by using his two medi- 
cines and following his advice I soon began to feel better and found myself 
pregnant, and words cannot express the happiness I felt. I am sorry, however, 
to say that I quit using them for a while and then by moving upstairs in a brick 
house, I had steps to climb, and greatly to my sorrow, had a miscarriage. I, 
however, again began taking Mitchella Compound and I am now delighted 
to say I am going on three months pregnant. I am enjoying the best of health 
and have all hopes of carrying this baby the full nine months. I bless the day 
I started to take Dr. Dye's remedies and strongly advise all women to give 
Mitchella Compound and Female Cones a fair trial. I recommend Dr. Dye's 
medicines to young and old — they save doctor's bills and are a help and saving 
to all. I cannot fully express my appreciation to Dr. Dye. My sincere wish 
is that he may live long to help suffering women. I write this hoping it maybe 
published. 

Box 282, Enid, Okla. MRS. GRACE WEISSINGER. 



426 



PAINLESS CHILDBIRTH 



INDEX 



Abdomen, enlargement of 59 
" pendulous - - 70 
Adenoids - - - 315 
Afterbirth - - - - 145 
Afterpains - - 168-170 
Age of wife - - - 18 
Albumen water - - 409 
Amenorrhoea - - 210-213 
Anaesthesia in labor 157-162 
Anteflexion of uterus - 243 
Anteversion of uterus - 242 
Appetite, depraved - - 98 
loss of - - - 99 
Arnold sterilizer - - 207 
Arrowroot juice - - - 410 
Artificial feeding - - 203 
Asthma - - - - - 332 
Attributes, sexual - - 1 

Babv, feeding of - - 201 
" full tub bath for - 180 
" how to bathe the - 180 
" rectal syringe - 129 
" rocking the - - 192 
" washing the new - 154 
" water for - - 193 
Baby's basket - - - 129 
" bathtub - - 129 
" bed - - - 130 
" binder - - - 156 
" wardrobe - - 130 
Barley water - - - 409 
Barrenness, frequency of 270 
Bathing ----- 65 
Bath, mustard - - 405 
" sitz - - - - 67 
" sponge - - - 405 
" temperature of differ- 
ent kinds - - 67 
" thermometer - 129 
Bed, how to prepare for 

labor - - - - 126 

Beef broth - - - - 408 

" essence - - 408 



tea 



- 408 



Binder, abdominal 127-182 

breast - - - 127 

Bladder - - - 24-56-184 

" irritability of - - 108 

" loss of control of 170 

Black Cohosh - - - 90 
Blue Cohosh - - - - 87 
Bones, composition of - 75-76 
Bowels, evacuation of baby's 184 
" gas in - - - 171 
" opening up after labor 171 
Breast, abscess of - 174-175 
" cancer of - - 267-268 
" care of, during preg- 
nancy - - 115-116 
' ' changes in , during preg- 
nancy - - 49-50 
" how to dry up milk in 176 
" inflammation of 174-175 
" nursing - - - 202 
" small and shrunken 

- - - - 266-267 
Breath, shortness of, in preg- 
nancy - - - 52 
Bronchitis, acute - - 316 
Cachexia, cancerous - - 258 
Caesarean section - 55 

Calomel, prescription for - 413 
Cancer of breast - - 267-268 
of uterus - 256-258 
Canker rash - - 369 

Cartilages, pelvic - - 51 
Cascara sagrada for constipa- 
tion ----- 93 
Catarrh, acute intestinal - 387 
Cerebro spinal meningitis - 354 
Change of life - - 258-261 
Chicken pox - - - 362 
Child attitude of, in womb 48 
" average weight of new- 
born - - - 39 
" bony development of 39 
Child-bearing, excessive - 7 
Child-bed fever - - 175-176 



INDEX 



427 



Chloasma - - - - 52 
Cholera Infantum - - 394 
Morbus - - - 390 
Cleanliness at confinement 

- - - - 166-167 
Clothing worn during la- 
bor - 125 

" during pregnancy - 69 
Code Napoleon - 133 

Cohosh, black - - - 90 

« blue - - - - 87 
Colds - - - - 308 
Colic ----- 188 
Compound licorice powder 93 
Conception - - - 5-44 
Confinement bed - - 126 

" how to foretell date of 

- - - - 54-55 

" preparations for - 124 

" room - - - - 125 
Constipation - - - 92-94 
Consumption - - - 325 
Contagious diseases, table of 339 
Convulsions - - - 110-305 
Cord, how and when to tie 144 

" how to dress - - 156 

" umbilical - - 154 
Cough during pregnancy - 104 
Cramps, treatment of - 114 
Cravings during pregnancv 98 
Crawling - - - -' 180 
Croup, membraneous - - 352 

" spasmodic - - 312 
Deformities of pelvis - - 35 
Delivery, dangers of too 

rapid - - - - 30 
Dentition - - - 194-196 
Depraved appetite during 

pregnancy - - - 98 
Determination of sex - - 74 
Diapers - - - - 184 
Diarrhoea, - - - - 379 

" in pregnancy - 102 

" summer - - 394 

Diet after confinement - 166 

" for pregnancy - - 79 
Dietetic measures - - 75 
Diphtheria - - - - 348 

" laryngeal - - 352 
Displacements of uterus - 241 



DobelFs Solution - - 412 
Douche, vaginal, how to take 
- - - - 227-229 



Dysentery - 
Dvsmenorrhoea 



384 
215 



" inflammatory - - 217 

" mechanical - - 220 

" membranous - - 218 

" neuralgic - - 216 

Egg water - - - - 409 

: Embryotomy - - - 35 

Eruptive diseases, table of 339 

Erysipelas - - - 378 

Excessive childbearing - 7 

" nursing - - - 7 

Excoriations - - - 302 

! Exercise - - - - 63 

Eyes, care of baby's - - 183 

" inflammation of - 183 

Fainting, treatment of - 106 

False pains - - - 136 

" pregnancv - - - 53 

Feet, swelling of - 110-111 

Fever mixture, prescription 

for - - - - - 413 
Fits ----- 305 
Flatulency - - - 99 
Flaxseed poultice - - 407 
tea - - - 409 
Foetal movements - 59-60 
" heartsounds - - 60 
Foetus, symptoms of death of 60 
Fomentations - - - 406 
Fontanelles, closure of - 179 
Fresh air and sunshine - 194 
Fumigate, how to - - 411 
I Gas in stomach and bowels 99 
" in bowels after labor 172 
; German measles - - 368 

I Hands, swelling of - 110-111 
1 Head, bones of, in child - 41 
Headache in pregnancy 103-104 
Hearing in infant - - 179 
Heart, the - - - 24-51 
Heartburn - - - 101 
Hemorrhage after de- 
livery - - - 163-164 
Hip ache - - - - 114 
Hoarseness, remedy for - 412 
Holding up of head - 180 



428 



PAINLESS CHILDBIRTH 



Hygienic management - 62 
Hymen, imperforate, test of 

virginity - - • - - 276 
Indigestion in infancy - 187 
Infant, average weight at 

birth - - - - 178 
Infant, average length at 

birth - - - - 179 
Infant, average size of head 179 
" care of - - 178-200 
Infection, puerperal - 175 
Infectious diseases, table of 339 
Influenza - - - 309 
Insomnia - - - - 113 
Interests of man and woman 8 
Intestine, acute catarrh of 387 
Involution of womb - - 165 
Inward fits - - - 306 
Itching of genitals - 105-106 
Jaundice in infancy - 192 
Junket - - - - 410 
Kidneys, care of during preg- 
nancy 94-95 



Labor, cause of - - - 


134 


" duration of - 


29 


" false pains of - - 


136 


" first stage of - 


139 


" management of - 


132 


" position of patient dur- 


ing - - - 


138 


" premature - - 


132 


" premonitory signs of 


134 


" second stage of - 


140 


" symptoms at com- 




mencement of - 


135 


" third stage of - 


143 


" true pains of - - 


136 


Lacing, results of tight - 


34 


La Grippe - - - 


309 


Laryngeal diphtheria - 


352 


Laryngitis, acute, remedy 


for - - - - 


412 


Laws of being - - 


8 


" of life - - - 


3 


Leucorrhoea - - -224 


-227 


Lightening - - - 


135 


Liver spots - - - 


52 


" " treatment of - 


107 


Living rooms - - - 


65 


Lochia - - - - 


166 



Longings - 
Love - - 
Lying-in-fever 
" " room 
Marriage - 



- - 98 

1 

- - 176 

125 
3 



early and late - 19-20 
Mask of pregnancy - - 52 
Maternal impressions - 71-74 
Maternity - - - 10-12 
Measles - - - - 363 
" German - - - 368 
Meconium - - - 157 
Medicine dropper - - 129 
Membranous croup - 352 
Meningitis, cerebro spinal 354 
Menorrhagia _ - - 221-223 
Menses, retention of - 210 
Menstruation, cessation of, sign 
of pregnancy - 56 
" irregular - - 214 
" vicarious - -" 223-224 
Milk, failure of breast - 176 
Miscarriage - - 117-122 
Mitchella repens - - 86 
Morning sickness - - 57 

Morning sickness, treatment 

of- - - - - 95-98 
Mother,care of, after delivery 163 
" influence of - - 17 
Mothers' marks - - 71-74 
Moth patches - - - 52 
" treatment of 107-108 
Mouth, sore, of nursing 

mothers - - - - 175 
Movements, foetal - 59-60 
Mumps - - - - 340 
Muscular system - - 37 

Mustard bath - - - 405 
" footbath - - 406 
" plaster - 406 

Naevi ----- 72 

Napoleon Code - 133 

Navel at end of pregnancy 51 
Neck of womb, softening of 59 
Nervous system in pregnancy 53 
Nervousness, treatment 

of - - - - 109-110 
Neuralgia during preg- 
nancy - - - 103-104 
Neutralizing mixture - 411 



INDEX 



429 



Nipples, care of 


- 115-116 


" changes in 


preg- 


nancy 


- - 49-51 


Nose bleed - - 


379 


Nurse, wet 


- - 193 


Nursery discipline 


198 


Nursing, breast 


- - 202 



" bottle, how to clean 207 
" excessive - - - 7 
" first - - - - 156 

" sore mouth - - 174 
Nymphomania - 4 

Oatmeal gruel - - 410 
" water - 410 

Offspring, avoidance of 15 

Ophthalmia neonatorum 183 
Ovaries, jdiseases of 263-265 
Ovum, changes in - 44-48 

Pain, causes of - - - 31 
Pains, false - - - 136 
" true labor - - 136 
Palpitation, treatment of 107 
Passion, sexual - - - 2-4 
Pasteurizer, Freeman's 207 

Pelvic cartilages - - 51 
Perineum, rigidity of - 38 

Phenophthalein in constipa- 
tion ------ 93 

Philoprogenitiveness - 10 

Piles - - - - 101-102 

Placenta - - - 145 

Pleurisy - - - - 320 

Plural births - - - 61 

Pneumonia- - - - 321 

Pregnancy, false or spurious 53 

" mask of - - - 52 

" protraction of - 132 

" signs and symptoms of 56 

Premature birth - - 117 

Preparation for confinement 124 

Profuse menstruation 221-223 

Prolapse of uterus - - 241 

Pruritus vulvae - 105 

Puerperal fever - - 175-176 

44 infection - - 175 

Quickening - - - 54-59 

Quinsy - 346 

Raw meat, scraped - - 408 

Reasoning powers - - 2 

Retention of menses - - 210 



Retroflexion of uterus - 243 
Retroversion of uterus 242 

Rice milk - 410 

" water - - - 409 

Rocking the baby - - 192 
Rooms, the living - - 65 
Rotheln - - - - 368 
Salivation - - - 58-115 
Scarlet fever - - - 369 
Sciatic pains in pregnancy 114 
Scraped raw meat - - 408 
Sepsis puerperal - - 176 

Septicaemia - 176 

Sex, determination of - - 74 
Sexes, attraction of - 3 

Sexual attributes - - 12 
" excesses - - - 67 
" passion - - - 2-4 
" questions - - 2 

" relations during preg- 
nancy - - 71 
Shortness of breath - 52 
Show, the - - - - 135 
Sight in infant - - 179 
Signs of disease in children 296 
Sitting alone - - 180 
Sitz bath - - - 67-68 
Skeleton, human - 40 
Slave women - - - - 26 
Sleep - - - - 68-69 
44 for infants- - - 181 
Sleeplessness, treatment of 113 
Smallpox - - - 357 
Softening of neck of womb 59 
Sore mouth of nursing 

mothers - - - - 175 

Sore throat - - - 342 

44 " prescription for 314 

Spasms - - - 305 

Speech in infants - - 180 

Spice plaster - - - 407 

Sponge bath - - - 405 

Spurious pregnancy - 53 

Squaw vine - - - - 85 

Standing alone - - 180 

Sterilitv - - - - 269 

44 causes of - 272-279 

44 treatment of - 276-292 

Stomach, the - 24 

Striae gravidarum - - 51 



430 



PAINLESS CHILDBIRTH 



Stricture of uterus - 261-262 
Subinvolution of uterus 250-252 
Suppression of menses - 213 
Teething- - - - 194 
Thrush , - - - 189-191 
Tight lacing, results of - 34 
Tonsillitis, prescription for 413 
Too rapid delivery - - 30 
Toothache during pregnancy 108 
Transmission, vital - - 7 
Triplets - - - - 61 

Tuberculosis - - - 325 
Tumors, fibroid - - 253 
" of uterus - - 252-256 
" pelvic - - - 35 

Turpentine stupe - - 407 
Twins - - - - 61 

Tympany - - 171 

Ulceration of womb 238-241 
Umbilical cord - - - 154 
Urine - - - - 
Uterus cancer of - 256-258 
" changes in during preg- 
nancy - - - 49 
" compared with other 

organs - - - 24 
" displacement of - 241 
" stricture of - 261-262 
" subinvolution of 250-252 
" tumors of- - 252-256 



Vaccination - - - 362 
Vaginal douche, how to take 227 
Vaginismus - - 262-263 
Varicella - - - - 362 
Varicose veins - - 100 
Vicarious menstruation 223-224 
Virginity, test of 276 

Vital transmission - 7 

Vomiting - - - - 304 
" in infants - - 186 
" of pregnancy - - 57 
Walking, first attempt at 180 
Wardrobe, baby's - - 130 
Weaning - - - - 197 
Weight, average of new born 39 
" gain in, during preg- 
nancy - - - - 52 
Wet nurse - - - 193 
Whey ----- 411 
Whooping cough - - 334 
Wife, age of - - - 18 
Womb, cancer of - - 256 
" chronic inflamma- 
tion of - 229-238 
" displacements of - 241 
" involution of - 164 
" stricture of - - 261 
" subinvolution of - 250 
" tumors of - - 252 
" ulceration of - 238 

Worms - 401 



JfiAn tj J; 



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- 



